Tattoo Consent Form
Sugar Beauty Studio
Client Information
Full Name
First Name
Last Name
Age
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
Format: (000) 000-0000.
Email
example@example.com
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
FEMALE ONLY: Pregnancy or Nursing?
Yes
No
Do you have a communicable disease?
Yes
No
Skin conditions (e.g. Rashes, 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.
Acknowledgment and Waiver
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 Sugar Beauty Studio LLC. portfolio showcased.
I acknowledge that Sugar Beauty Studio LLC. does not offer refunds.
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 understand that I need to take care of the tattoo by following the instructions given to me by Sugar Beauty Studio LLC.
I understand that I might get an infection if I don't follow the instructions given to me in regards of taking food care of my tattoo. I understand that I need to refrain from using pain meds or caffeine the day of my appointment. I understand that I need to advise if I’m using retin-a, accurate, or other products that have strong effects on the skin.
I indemnify and hold harmless Sugar Beauty Studio LLC. against any claims, expenses, damages, and liabilities.
I confirm that the information I provided in this document is accurate and true.
Signed Date
-
Month
-
Day
Year
Date
Client Signature
Submit
Should be Empty: