Consent Release Form

blanksI am not under the influence of alcohol or drugs.

blanksI do not have acne, freckles, moles, or sunburn in the area to be tattooed that might be agitated by the tattoo process (healing excluded).

blanks I have looked over my design, checked the spelling if applicable, and give my full consent to the application of my tattoo.

blanksI acknowledge that I am not pregnant.

blanksI acknowledge that I am free of communicable disease.

blanksI acknowledge that I have truthfully represented to the artists of Self Care Tattoo Company that I am over eighteen (18) years of age.

blanksI acknowledge it is not reasonably possible for the artists of Self Care Tattoo Company to determine whether I might have an allergic reaction to the dyes, pigments, or processes used in my tattoo and I agree to accept that such risks are possible.

blanksI acknowledge that infection is always possible as a result of obtaining a tattoo particularly in that event that I do not take proper care of my tattoo, and I have been advised of the signs and symptoms of infection that indicate a need to seek medical care.

blanksI acknowledge receipt of written instructions advising me of proper care of my tattoo and recognize the absolute necessity of following those written instructions. All questions about the body art procedure have been answered to my satisfaction.

blanksI acknowledge that variations in color and design may exist between any tattoos as selected by me and as ultimately applied to my body.

blanksI acknowledge that tattooing is a permanent change to my appearance and that no representations have been made to me as to the ability to later chance, alter, or remove my tattoo

blanksI acknowledge that the obtaining of my tattoo is my choice alone and I consent to the application of the tattoo and to any actions or conduct of the artists at Self Care Tattoo Company that are reasonably necessary to perform the tattoo procedure.

blanksI agree to release and forever discharge and forever hold harmless Self Care Tattoo Company and its artists from any and all claims, damages, or legal actions arising from or connected in any way with my tattoo, or the procedures and conduct used to apply my tattoo and any and all tattoos applied by Self Care Tattoo Company artists in the future.

blanksI acknowledge that tattoo inks, dyes, and pigments have not been approved by the federal Food and Drug Administration and the health consequences of using these products are unknown.

blanksI acknowledge that there is a chance I might feel lightheaded, dizzy during or after being tattooed. I agree to immediately notify the artists in the event I feel lightheaded, dizzy, and/or faint before or during the procedure.

blanks I agree to follow all instructions concerning the care of my tattoo, and that any touch-ups needed because of my own negligence will be done at my own expense.

I (print name) blanks blank have been fully informed of the risks of tattooing including but not limited to infections, scarring, difficulties in detecting melanoma, and allergic reactions to tattoo pigment, latex gloves, and antibiotics.  Having been informed of the potential risks associated with getting a tattoo, I still wish to proceed with tattoo application, and I assume any and all risks that may arise from tattooing.