TATTOOS CONSENT 2021

Tattoo Consent Form

Client Information
Full Name

First NameLast Name
Are you 18+?
Have you chosen your desired tattoo?
Desired Tattoo Placement
If you have a referance photo, you may upload here:

Browse Files

Cancelof
Date of Birth

MonthDayYear
Date
Phone Number

+44Phone Number
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Pre-Procedure Questionnaire
Do you understand being under the influence of either drugs or alcohol is both prohibited and not recommended?
Pregnancy or Nursing?
Do you have a communicable disease/virus (e.g.Hep B, Hep C ,Hep D, HIV )? This information is private and only shared with your artist, Amara Nicole.
Skin conditions (e.g. Rashes, eczema, infection, psoriasis, freckles, etc.)
If yes, please identify the condition.
Medical History (e.g. Diabetes, Cardiovascular Disease, Epilepsy, Blood-related disease etc.)
If yes, please identify the condition.
Are you taking any prescribed medication regularly (especially any anticoagulant such as warfarin, aspirin immuno-suppressants such as steroids
If yes please give details
Any allergic responses to metals/Plasters or creams/latex or anything else we should know
If yes please give details
Any known/previous reaction to dye pigments?
If yes please give details
Acknowledgment and Waiver
Have you scheduled & paid your deposit on our booking site?
Client Signature
Should be Empty:

Tattoo Consent Form