Tattoo Consent Form
Name
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Preferred Name
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I prefer not to disclose
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I am 18 years of age or older
I am not currently pregnant or nursing
I am not under the influence of recreational drugs or alcohol
I do not have a history of hemophilia, bleeding disorders or are on any medication that may increase bleeding
I am not undergoing chemotherapy, nor have I gone through chemotherapy in the past 12 months
I do not have diabetes
I am not prone to keloid scarring
I do not currently have any type of infection and/or rash anywhere on my body
I do not have sensitivities to dyes, pigments or topical anesthetics (example: Lidocane)
I certify that I am not HIV-positive or have AIDS.
I consent to have Jorden Wormwood perform this tattoo
I acknowledge that:
*
I understand that getting a tattoo involves the use of pigments and ink, and I acknowledge the possibility of having an allergic reaction to these substances. I accept the inherent risk of such a reaction.
I acknowledge that there is a risk of infection as a result of the tattoo procedure, especially if proper aftercare instructions are not followed diligently.
I am aware that variations in color may exist between the chosen tattoo design and how it will ultimately appear after the healing process is complete.
I understand that immediately following the tattoo procedure, the ink may appear darker for the initial six (6) days and will gradually lighten over time.
I recognize that achieving the desired final result may require returning for at least one (1) touch-up appointment. These touch-up appointments are crucial for refining or enhancing specific areas of the tattoo. These appointments will not be scheduled earlier than four (4) weeks after the last appointment.
I understand that skin treatments, including but not limited to laser procedures, plastic surgery, or other alterations to the skin in the tattoo area, may result in adverse changes to the appearance of the tattoo.
I acknowledge that Frank + Olive does not provide refunds for tattoo services that have been performed.
Photo Release
I consent to the use of my photos for the purpose of marketing. My pictures may appear in print or online.
Name
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Date
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Please upload a clear image of a valid government-issued photo ID. This helps us verify your identity and ensures that we comply with legal and safety standards.
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