Tattoo release form
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I AM ABOVE 18 YEARS OLD
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Full Name
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First Name
Last Name
E-mail
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Phone
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Area Code
Phone Number
Date of birth
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Месяц
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День
Год
Date
Are you HIV positive?
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Yes
No
Do you have hepatitis?
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Yes
No
Are you hemophiliac?
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Yes
No
Are you prone to fainting?
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Yes
No
Are you pregnant?
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Yes
No
Have you consumed alcohol in the past 8 hours?
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Yes
No
Are you an intravenous drug user?
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Yes
No
Do you have any allergies?
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Yes
No
Are you epileptic? (do you have seizures?)
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Yes
No
Are you taking any medications?
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Yes
No
Do you have low blood sugar?
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Yes
No
Select tattoo artist
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Sean
How did you find us
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TattooDo
I Agree to purchase the suggested aftercare product provided at Jewels Parlor
I have declined to purchase the suggested aftercare product provided at Jewels Parlor
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I agree to have Jewels Parlor tattoo my body, and in consideration of doing so, I hereby release Jewels Parlor, its employees, and its agents from all manner of liabilities, claims, actions and demands in law or in equity, which I, or my heirs, have no or hereafter by reason of my complying with my request to be tattooed. I understand that I will be tattooed using appropriate instruments and techniques to ensure proper healing for my tattoo. I agree to follow the procedures outlined in the Jewels Parlor aftercare instructions until healing is complete. I understand that my tattoo takes 1 month or longer to fully heal. I acknowledge that I am at least 18 years old. I acknowledge that all the information above is correct to best of my knowledge and by signing: I confirm that the above is true.
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