Bloom Tattoo Consent

PLEASE INITIAL IN THE BOXES PROVIDED AFTER READING TO SHOW THAT YOU

UNDERSTAND EACH PROVISION. FEEL FREE TO ASK ANY QUESTIONS REGARDING THIS

I, (Print Name) have been fully informed of the inherent risks with getting a tattoo. Therefore, I fully understand that these risks, known and unknown, can injury including but not limited to: infection, scarring, difficulties in the detection of melanoma allergic reactions to tattoo pigment, latex gloves and/or soap. Having been informed of the potential associated with getting a tattoo I wish to proceed with the tattoo procedure and application and accept and expressly assume any and all risks that may arise from tattooing.

I WAIVE AND RELEASE to the fullest extent permitted by law to Bloom Tattoo liability whatsoever, including but not limited to, any and all claims or causes of action that I, my heirs, executors or assigns may have for personal injury or otherwise, including any direct and/or damages, which result or arise from the procedure and application of my tattoo.

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Bloom Tattoo has given me the full opportunity to ask any question about the and application of my tattoo and all of my questions, if any, have been answered to my total

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Bloom Tattoo has given me instructions on the care of my tattoo while it's I understand and will follow them. I acknowledge that it is possible that the tattoo can become particularly ifl do not follow the instructions given to me. If any touch up work to the tattoo is due to my own negligence, I agree that the work will be done at my own expense.

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I am not under the influence of alcohol or drugs, and I am voluntarily submitting to be tattooed by Bloom Tattoo without duress or coercion.

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I do not suffer from diabetes, epilepsy, heart condition(s), Keloids, Moles, Psoriasis, or Sunburn, I take blood thinning medication. I do not have any other medical or skin condition that may with the procedure, application or healing of the tattoo. I am not the recipient of an organ or marrow transplant or, if I am, I have taken the prescribed preventative regimen of antibiotics that is by my doctor in advance of any invasive procedure such as tattooing or piercing. I am not or nursing. I do not have a mental impairment that may affect my judgement in getting the

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I do not have any known allergies to essential oils

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I acknowledge that if have any allergies to adhesives, I will advise my tattoo artist before the procedure.

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Bloom Tattoo is not responsible for the meaning or spelling of the symbol or text have provide to them or chosen from the flash (design) sheets.

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Variations in color and design may exist between the tattoo art I have selected and the actual when it is applied to my body. I also understand that over time, the colors and the clarity of my will fade due to unprotected exposure to the sun and the naturally occurring dispersion of pigment the skin.

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A tattoo is a permanent change to my appearance and can only be removed by laser or surgical means, which can be disfiguring and/or costly and which in all likelihood will not result in the restoration of my skin to its exact appearance before being tattooed.

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I understand if have any type of skin treatments, Laser Hair Removal, Plastic Surgery, or any altering procedures it may result in adverse changes to my tattoo.

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I release the right to any photographs taken of me and the tattoo and give consent in advance to reproduction in print or electronic form. (For assurance, if you do not initial this provision, please inform Bloom Tattoo NOT to take any pictures of you and your completed tattoo).

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I agree that Bloom Tattoo has a NO REFUND policy on tattoos and I will not ask refund for any reason whatsoever.

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I acknowledge that I have been given adequate opportunity to read and understand this that it was not presented to me at the last minute and grasp that I am signing a legal contract certain rights to recover damages against Bloom Tattoo.

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I understand that if any type of infection or rash start to appear on the tattooed area after the procedure, I will advice Bloom Tattoo and/or your physician.

I hereby declare that I am of legal age (and have provided valid proof of age and identification) and am competent to sign this Agreement.

I HAVE READ THE AGREEMENT, I UNDERSTAND IT, AND I AGREE TO BE BOUND BY IT.

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