Tattoo Consent and release of liability Form
Client Information
All information in confidential
Full Name
*
First Name
Last Name
Age
*
Date of Birth
*
-
Month
-
Day
Year
Date
Phone Number
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Pre-Procedure Questionnaire
Are you under the influence of drugs or alcohol?
*
Yes
No
Are you pregnant
*
Yes
No
Do you have a communicable disease?
*
Yes
No
Skin conditions (e.g. Latex or Adhesive allergies, eczema, infection, psoriasis, freckles, etc.)
If yes, please identify the condition.
Medical History (e.g. DIabetes, Cardiovascular Disease, Epilepsy, Blood-related disease etc.)
If yes, please identify the condition.
All numbing must be discussed with your artist, clients who show up for thier appointment with any preapplied numbing creams will not be tattooed that day. All numbing agents must be applied by one of our qualified artists.
*
I understand and agree to these terms
Acknowledgment and Waiver
I understand that my artist may make certain design decisions to allow for my tattoo to age well, fit certain body shapes, etc… I agree to allow my artist the freedom needed to ensure my tattoo is completed to the best of their ability.
*
I understand and agree to these terms.
*
I understand that this procedure is a permanent change to my skin and body.
*
I allow my tattoo to be photographed and be used for Portfolios and Social media marketing.
*
I acknowledge that the Ink Excess Tattoo Studio does not offer refund.
*
I understand that I need to take care of the tattoo by following the instructions given to me by my artist at Ink Excess Tattoo Studio
*
I agree that the studio does not have a way of identifying if I am allergic to the elements or ingredients that will be used for my tattoo.
*
I indemnify and hold harmless ink excess tattoo studio and any of the artists contracted by this studio against any claims, expenses,damages and liabilities.
*
I understand that I might get an infection if I don't follow the instructions given to me regarding taking proper care of my tattoo.
*
I confirm that the information I provided in this document is accurate and true.
Touch up Policy: If you are in need of a Touch up, contact us within 30 days of getting the tattoo, to get scheduled for a free touch up. Failure to do so you will be charged for a touch up. -Certain spots such as fingers, palms, knees, elbows, side of feet, or other spots that are prone to not aging well. For these spots there will be a touch up fee.
*
I understand and agree to these terms
Deposits are non-transferable from artist to artist and non-transferable from client to client. If you start a project with an artist and for unseen circumstances you are unable to get tattooed. Wether that be financial or medical reasons, we will honor the current deposit for 6 months from your last scheduled appointment. After 6 months the deposit or previous price agreement will be voided and we will require a new deposit and may set a new price for the project.
*
I understand and agree to these terms
Signed Date
*
-
Month
-
Day
Year
Date
Client Signature
*
Drivers license or photo ID picture
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: