Fierce Ink Tattoo Booking + Consent Form

**** ALL CLIENTS ARE REQUIRED TO ACCEPT THE CANCELLATION POLICY UPON REQUESTING TO BOOK AN APPOINTMENT. IF YOU ARE FILLING OUT THIS FORM, THAT MEANS YOU HAVE ALREADY AGREED AND ACCEPTED OUR CANCELLATION POLICY (see image below). OUR CANCELLATION POLICY IS LISTED IN MULTIPLE LOCATIONS AND AVAILABLE TO CLIENTS. WE HAVE POLICIES IN PLACE FOR A REASON, PLEASE RESPECT THEM.

  

PLEASE READ + SIGN TO AGREE TO ALL INFORMATION BELOW:

 

The nature and method of the proposed fine line tattoo procedure has been explained to me as having the usual risks inherent in the procedure and the possibility of complications during and following its performance. I understand that there may be a certain amount of discomfort or pain associated with the procedure and that other possible adverse side effects may include: minor and temporary bleeding, bruising. redness or other discoloration and/or swelling. Fading or loss of pigment may occur. Secondary infection in the area of the procedure is rare if properly cared for but may occasionally occur.

 

By signing below. I specifically acknowledge that I have been advised of the facts and matters set below, and I agree as follows: (Please sign below to agree that you clearly understand each statement) 

 

I have informed the practitioner of any and all of my known allergies. I acknowledge that it is not always reasonably possible to determine in advance whether I might have an allergic reaction to any of the pigments, dyes, topical preparations, latex, iodine, or processes used in the procedure; and I agree to accept the risk that such reaction is possible.

I understand that there are side effects that include but are not limited to vomiting, fainting, dizziness, and bacteria endocarditis.

I have informed the practitioner of any medical condition that may affect my ability to be a candidate for these services including hepatitis, diabetes, and/or jaundice in the last 12 months.

I acknowledge that complications as a result of tattoo procedures may occur, particularly in the event that the post-procedural instructions are not followed, and accept full responsibility for such complications.

I have not ingested blood thinners such as aspirin or ibuprofen within 24 hours prior to this appointment.

I have not consumed alcohol or other intoxicants at least 24 hours to this appointment.

I do not have any conditions that might affect the procedure or healing process such as lupus, diabetes, or hemophilia.

I have eaten at least 2 hours before this appointment.

I realize that my body is unique and neither the practitioner nor its employees or contractors can predict how my skin may react as a result of the procedure.

I have previously had a tattoo performed by someone other than the practitioner today on the same area that I am asking the practitioner to work on today YES OR NO
IF YES, I understand that correcting or touching up tattoos that were performed by others involves additional risks because of the existence of permanent pigments of unknown composition, brand, color, age. shape and other factors over which your practitioner has no control.

I understand that additional appointments after the initial and follow-up appointments may be required, and will be billed at the practitioner's standard rates.

I understand that the practitioner cannot predict the results in advance and cannot guarantee and has not represented that the results will be as desire.

I understand and fully accept the risks associated with this procedure and hold the practitioner harmless from same.

I acknowledge that the procedure may result in a long-lasting (many years) change to my appearance and that no representations have been made to me as to the ability to later change or remove the results.

I understand that future skin altering procedures such as laser treatments, plastic surgery, implants, and/or injections may alter and degrade my tattoo and that I must inform any future service provider that I have had a tattoo. I understand and accept that such changes are not the fault of practitioner or its employees or contractors. I further understand that such changes or degradation in my appearance may not be correctable through further procedures.

I consent to the admittance of authorized observers to the procedure(s) for the purpose of education or assistance.

I acknowledge that obtaining the tattoo is my choice alone, and I consent to the procedure and to its attendant risks, and to any actions or conduct reasonably necessary to perform the procedure.

I understand that I will have the opportunity to approve the design and color of the tattoo to be applied, and I accept responsibility for same.

I consent to any relevant photographs being taken before, during, and after the procedure, to document the results of the procedure and/or educational purposes for use of practitioners business.

I consent to the practitioner using before & after" photos of me for marketing purposes to display its capabilities and results.

I have been given the full opportunity to ask any and all questions which I have about obtaining tattoo procedures from the artist and that all of my questions have been answered to my full and total satisfaction.

I have read and understand the contents of each statement above. I acknowledge that this is a contract and that I have received no warranties or guarantees with respect to the benefits to be realized from, or consequences of the before mentioned procedure(s). I further acknowledge that at the time of signing this consent I am of sound mind and capable of making independent decisions for myself.

By signing below. I acknowledge, understand and agree that: 

· the practioner does not practice medicine, does not accept health insurance, and has made no representation to the contrary: 

· the information provided on this form is accurate and complete to the best of my knowledge, and that my practitioner is not responsible for complications or problems arising from any incorrect or omitted information: 

· some individuals will have complications related to the tattoo service. These complications are usually mild and last only a few days. However, extreme complications are always a possibility. Risks include but are not limited to: fainting, vomiting, and infection including bacterial endocarditis for patrons with a heart condition. I accept these risks and agree to hold my practitioner harmless for the same; my practitioner will use the information provided above to assess my suitability for the proposed permanent cosmetics or tiny tattoo services. 

 

· I am completely satisfied with my tattoo service when I leave 

AFTERCARE:

The Do’s
+Wash your hands with antibacterial soap before cleaning or touching your tattoo.

+ Keep your bandage on for at least 5-7 days. 

+ When removing your bandage, rinse tattoo with warm water and clean paper towel.

+ Wash twice a day with just warm (not hot) water and/or mild fragrance-free liquid soap, and apply a thin layer of healing balm from day 2 onwards. Avoid lotions with fragrances or aloe.

+ If possible, use freshly washed bedsheets, clothes, and towel during healing process. Disposable paper towels or unscented baby wipes are great for direct contact with the tattoo when washing or drying. 

 

 

The Don’ts

+ Do not scratch or pick. This removes ink and leads to infections!

+ Avoid direct sunlight. For the first two weeks try to limit sun exposure - if you know you'll be out in the sun for prolonged periods, wear a thin layer of clothing over the tattoo. After the first two weeks, use a high SPF sunscreen on your tattoo when in the sun. Avoid tanning beds for at least a month.

+ Avoid soaking in any waters (lake, ocean, bathtub, pool) for the first month, especially critical during the first two weeks.

+ Avoid heavy sweating in the area of your tattoo for two weeks. Wash after sweating.

+ Do not let your tattoo stick to sheets or clothing. If stuck, soak the cloth to remove rather than ripping it off. This is usually only a concern for the first night when it will be a bit oozy.

 

I HAVE READ AND UNDERSTAND THE AFTERCARE INSTRUCTIONS. I ACCEPT THAT FAILURE TO FOLLOW THE POST-PROCEDURE INSTRUCTIONS MAY RESULT IN A LOSS OR DISCOLORATION OF PIGMENT RESULTING IN A NEED FOR MORE FREQUENT TOUCHUPS. NO GUARANTEES, NO REFUNDS.