Tattoo Questionnaire and Consent

Tattoo Questionnaire and Consent

Ink’d Realizm
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Birthdate

MonthDayYear
Date
NoYes
How Many Tattoos are you looking to have designed?
Where would you like your tattoo design(s)?
Is this a cover-up? Yes or No
NoYes
NoYes
NoYes
Skin conditions (e.g. Rashes, eczema, infection, psoriasis, freckles, etc.)
Please provide me with high quality reference images to better help me understand your vision.
Reference Image #1

Cancelof
Reference Image #2

Cancelof
Reference Image #3

Cancelof
Reference Image #4

Cancelof
Reference Image #5

Cancelof
Thank you for choosing to book with me! I will be in touch with you within 3-5 business days.
Acknowledgement & Waiver
I understand that this procedure is a semi-permanent (PMU) or permanent change (tattoo) to my skin and bodyI allow my tattoo to be photographed and showcased in my tattoo portfolio on my social media platforms and promotional material.I acknowledge that refunds are not available after the procedure has been completed.I understand that the tattooer does not have a way of identifying if I am allergic to the elements or ingredients that will be used for my tattoo.I agree that it is my responsibility to follow the after care instructions to prevent an infection.
The primary purpose of this consent form is to fully educate future clients like yourself about the procedure you will be undergoing. This is also the stage where you can ask me any questions you may have about the design(s) and/or procedure and in order for you to have peace of mind.

I want this to be an amazing experieince for you and I look forward to working with you.
Date

MonthDayYear
Date
Signature

Powered by Jotform SignClear
Should be Empty:

Tattoo Questionnaire and Consent

Acknowledgement & Waiver