Tattoo Consent Form

Tattoo Consent Form

Please complete this form to the best of your knowledge. Thank you.
Name

First NameLast Name
Appointment Date

DayMonthYear
Email
example@example.com
Phone Number
Address

Street Address

Street Address Line 2

Town / CityState / Province

Postcode
Date of Birth

DayMonthYear
If you are under 21, please add an image of your photo ID.

Eg. Your driving licence, passport or a student card.
Cancelof
Your GP surgery name and town/city
Emergency Contact Name
Emergency Contact Phone Number
Short Description of Tattoo + Placement
Do you have any of the following conditions? Please tick all that apply.
If you ticked any of the above boxes, please give relevant details.
Please indicate that you agree to each of the following:
Do you consent to images and videos of your tattoo being shared on social media?
If you ticked yes, please share your Instagram username below.
Client Signature
Today's Date

DayMonthYear
Date
Should be Empty: