Tattoo Procedure Consent Form
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I acknowledge by signing this agreement, that I have been given the accurate and full information on the procedure of obtaininga tattoo, and I give my full consent on the application of it. As this procedure involves minor breakage of the skin with a needle, I understand the health risks, therefore I am obliged by law to declare any conditions that will affect this procedure.
I am feeling well and able to go ahead with the procedure
I am over the age of 18, and able to provide proof if needed
I have eaten in the las 2 hours
I have not consumed drugs or alcohol in the last 24 hrs
My blood pressure is regular
I have no heart conditions
I do not have any conditions that compromise my immune system
I am not allergic to the Penicillin family of drugs
I am not diabetic
I do not have any blood clotting disorder
I am not pregnant or breast feeding
I do not suffer of any form of seizure causing condition
I am not prone to dizziness or fainting
I understand that the tattoo procedure by the artist is carried in the best hygienic manner and the aftercare of the tattoo is my sole responsibility
I understand that reaction to ink pigments is still possible , even after the tattoo is healed
I consent to any actions or conduct of the representative of the tattoo shop necessary to perform the procedure
Any other health related information
Email
example@example.com
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Street Address
Street Address Line 2
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