Tattoo Consent Form

Tattoo Consent Form

The information supplied bellow is confidential and for professional use of the your artist only.
Ask your Artist what to enter bellow
Practitioner Artist
Ink Brand used
Tattoo Body location
Pre-Procedure Questionnaire
FEMALE ONLY: Are you pregnant or nursing?
Do you have a communicable disease? (It's okay if you do, we just want to know for our and other's safety).
Do you have any skin conditions?
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.)
If yes, please identify the condition.
Acknowledgment and Waiver
RISKS

I have been fully informed of the inherent risks, associated with getting a tattoo. I fully understand that these risks, known and unknown, can lead to injury, including but not limited to infection, scarring, difficulties in detecting melanoma and allergic reactions to tattoo pigment , aftercare bandages, latex gloves, and/or soap. Having been informed of the potential risks, I still wish to proceed with the tattoo application and I freely accept and expressly assume any and all risks.
PERMANENT
LEGAL AGE
PHOTOGRAPY
TATTOO VARIATIONS
AFTERCARE & HEALING
REFUNDS
WAIVE

TO WAIVE AND RELEASE to the fullest extent permitted by law each of the Artist and the Studio from all liability whatsoever, for any and all claims or causes of action that I, my estate, heirs, executors or assigns may have for personal injury or otherwise, including any direct and/or consequential damages, which result or arise from my tattoo, whether caused by the negligence or fault of either the Artist or the Tattoo Studio, or otherwise.
QUESTIONS
Client Information
Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Take Front Photo of your Drivers License
Client Signature
Signed Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Tattoo Consent Form

Ask your Artist what to enter bellow

Pre-Procedure Questionnaire

Acknowledgment and Waiver

Client Information