Tattoo Consent Form

Tattoo Consent Form
Client Information
Name*

First NameLast Name
Prefered name
Prefered pronouns
Age*
Birth Date*

DayMonthYear
Date
Phone Number*

Area CodePhone Number
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Post CodeCountry
Artist
Name of your tattoo artist
Pre-Procedure Questionnaire
Are you under the influence of drugs or alcohol?*

YesNo
Are you pregnant or nursing?

YesNo
Do you have a communicable disease?*

YesNo
Communicable diseases (e.g. Tuberculosis, Coronavirus, Dengue, Hepatitis, Measles, HIV/AIDS. etc.)
If yes, please identify the condition.
Do you have any skin conditions?*

YesNo
Skin conditions (e.g. Rashes, eczema, infection, psoriasis, freckles, etc.)
If yes, please identify the condition.
Please tell about your medical history (e.g. diabetes, cardiovascular disease, epilepsy, blood-related disease, blood thinning medication, hypermobility/EDS, chemo or radiotherapy 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 for those photos to be used on my artist and Blank Collective's websites and social media accounts.
*

I acknowledge that Blank Collective 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 my artist.
*

I understand that I might get an infection if I don't follow the instructions given to me in regards of taking good care of my tattoo.
*

I indemnify and hold harmless both Blank Collective Ltd. and my artist against any claims, expenses, damages, and liabilities.
*

I confirm that the information I provided in this document is accurate and true.
Signed Date

DayMonthYear
Date
Client Signature*
Please upload a photo of a valid form of ID (passport or driving license).*

Browse Files

Cancelof
Should be Empty:

Tattoo Consent Form

Client Information

Pre-Procedure Questionnaire

Acknowledgment and Waiver