N.U INK Client Consent Form
  • N.U INK Client Consent Form

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
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  • MEDICAL HISTORY

  • How long has it been since you ate?*

  • Please list any medications/vitamins you are currently taking. *

  • Patch Test

  • Possible Risks, Hazards, Complications or Pain.

    There can be pain even after topical anesthetics have been used. Pain is minimal.

    Infection- Infection is very rare. The areas treated must be kept clean and only freshly cleaned hands should touch the areas.

    Excessive swelling and bruising is normal. Some people bruise and swell more than others.

    Swelling disappears in 1-5 days. Topical anesthetics are used to numb the area to be tattooed.

    Lidocaine, prilocaine, Benzocaine, Tetracaine and Epinephrine in a cream or gel form are typically used.

    If you are allergic to any of these please inform your technnician.

  • Photography/Video Consent

  • AFTERCARE

  • GENERAL AFTERCARE

    For the next two weeks, keep treated area clean and dry
    Sleep with a clean pillow case and try to sleep on your back the night of
    Do not let treated area get wet for 24 hours after your appointment
    Scabbing and peeling is normal. Do not pick the scabs as it will pull the pigment out.

     

    Avoid direct sunlight, chlorine, steam or excessive sweating, and makeup or other products on treated area for the next two weeks
    Pigment will get lighter and darker through the healing phase. A 6-8 week touch up is not included in the appointment cost and is needed, along with proper aftercare, for your best chance at desired results
    The brand of aftercare ointment and wash we supply in the aftercare bag is Mild Dial soap and Aquaphor. Please keep aftercare ointment and wash for your touch-up appointment. 

    BROWS

    I will provide you with cotton rounds. For each hour after your appointment you need to blot the lymph off of your brows. I will provide ointment, and you can apply a rice-sized amount to your brows the first night. Starting the next day, gently wash your brows with your fingertips and provided wash. Pat dry with a clean towel and apply the same ointment. You should do this 1-2 times a day until they start peeling, then let them be. Do not pick the scabs, as this will pull the pigment out.

    LIPS

    No spicy foods the day of your appointment and drink from a straw. Your lips will be swollen and sore the day of your appointment. You may ice them on and off for 15 minutes for an hour the night of the appointment. Let your lips completely dry out for the next 24 hours and do not apply any products. The next night before bed, you may start applying vaseline and Aquaphor at least 4 times a day, but as often as you would like. Use a disposable mask for the next two weeks and change at least daily. Lip touch up is recommended 8-16 weeks after your initial appointment. Your color will not fully flourish until 3-4 months after your touch up.

    EYELINER

    Do not wear contacts for the first 24 hours after your appointment. Apply a pea-sized amount of provided ointment to treated area before bed. Starting the next day, gently wash and blot dry with a clean towel, and provide a pea-sized amount of ointment. Rinse with Blink eyedrops or pure saline if your lashes are sticking together. Do not wear mascara or other eye makeup for the next two weeks. You may ice your eyelids on and off for 15 minutes for an hour if your eyes are swollen or sore. See your eye doctor for any serious concerns. 

  • INFORMED CONSENT TO RECEIVE BODY ART

    PLEASE READ AND SIGN WHEN YOU ARE CERTAIN YOU UNDERSTAND THE IMPLACATIONS OF SIGNING.


  • I understand that a tattoo is considered permanent and may only be removed with a surgical procedure.

    I understand that any effective removal of a tattoo or body piercing may leave scarring.

    I am not under the influence of alcohol or drugs and that I am voluntarily submitting myself to receive body art without duress or coercion.

    I acknowledge the information I provided in the medical questionnaire is complete and true to the best of my knowledge.

    The body art described or shown on this form is correctly placed to my specifications.

    All questions about the body art procedure have been answered to my satisfaction, and I have been given written aftercare instructions for the procedure I am about to receive.

    I understand the restrictions associated with this body art procedure as explained by the technician.

    I understand that any medical information obtained may be subject to the federal Health Insurance Portability and Accountability Act of 1996 (HIPPA).

    I am aware of the signs and symptoms of infection, including but not limited to, redness, swelling, tenderness of the procedure site, red streaks going from the procedure site towards the heart, elevated body temperature, or purulent draining from the procedure site.

    I understand there is a possibility of getting an infection as a result of receiving body art.

    I will seek professional medical attention if signs and symptoms of infection occur.

    I agree to follow all instructions concerning the care of my body art procedure and that any touch-ups needed due to my own negligence will be done at my own expense.

    I understand that there is a chance that I might feel lightheaded or dizzy during or after being tattooed.

    I agree to immediately notify the artist in the event I feel lightheaded, dizzy, and/or faint before, during or after the procedure.

  • I, have been fully informed of the risks of body art including but not limited to infection, scarring, and allergic reactions to items associated with body art procedures. Technician will not perform the body art procedure if you fail to complete or sign this form. Further, technician may decline to perform a body art procedure if the client has any identified health conditions. Having been informed of the potential risks associated with this body art procedure, I still wish to proceed with the body art application and I assume any/all risks that may arise from body art.

     

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