Tattoo Consent Form

Tattoo Consent Form
Client Information
Name

First NameLast Name
Age
Birth Date

MonthDayYear
Date
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Pre-Procedure Questionnaire
Are you under the influence of drugs or alcohol?

YesNo
Have you had any exposure to covid in the last 10 days

noyes
do you have any noticeable symptoms of covid (sniffly nose, sore throat, headache, fever, sluggishness, etc)

noyes
Are you pregnant or nursing?

YesNo
Do you have a communicable disease?

YesNo
Do you have any skin conditions?

YesNo
Skin conditions (e.g. Rashes, eczema, infection, psoriasis, freckles, etc.)
If yes, please identify the condition.
Please tell about your medical history (e.g. Diabetes, Cardiovascular Disease, Epilepsy, Blood-related disease etc.) Specify if you have a disability or will need special accommodations.
If yes, please identify the condition.
Acknowledgment and Waiver
I understand that this procedure is a permanent change to my skin and body.
I allow my tattoo to be photographed and posted on Instagram and online portfolio.
I acknowledge that the tattooer does not offer refunds.
I agree that the studio does not have a way of identifying if I am allergic to the elements or ingredients that will be used for my tattoo.
I understand that I need to take care of the tattoo by following the instructions given to me by the tattooer.
I understand that it’s possible to get an infection if I don't follow the instructions given to me with regard to taking care of my tattoo.
I indemnify and hold harmless the tattooer against any claims, expenses, damages, and liabilities.
I confirm that the information I provided in this document is accurate and true.
Signed Date

MonthDayYear
Date
Client Signature
Upload a photo of your ID here

Cancelof
Should be Empty:

Tattoo Consent Form

Client Information

Pre-Procedure Questionnaire

Acknowledgment and Waiver