You can always press Enter⏎ to continue
Welcome
Hi there, please fill out and submit this form.
43
Questions
START
1
Full Legal Name
*
This field is required.
First Name
Last Name
Previous
Next
Submit
Press
Enter
2
Preferred Name
OR NICKNAME
Previous
Next
Submit
Press
Enter
3
Personal Gender Pronouns
He/ Him
She/Her
They/Them
Other
Previous
Next
Submit
Press
Enter
4
Mailing Address
*
This field is required.
Street Address
Apt / Unit Number
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Previous
Next
Submit
Press
Enter
5
Email
*
This field is required.
We will use your email only for confirmation of appointments, receipts and occasional updates about our business: including sales and specials.
example@example.com
Confirm Email
Previous
Next
Submit
Press
Enter
6
Cell Phone
*
This field is required.
This will be used only for communication purposes, and appointment reminders.
Area Code
Phone Number
Previous
Next
Submit
Press
Enter
7
Date of Birth
*
This field is required.
/
Date of Birth
Month
Day
Year
Previous
Next
Submit
Press
Enter
8
Covid Test Required - Please Upload a photo result of the test you took with the last 24 hours.
*
This field is required.
REGARDLESS OF VACCINATION STATUS, WE ARE REQUIRING A NEGATIVE COVID TEST SUBMITTED FOR APPOINTMENTS LASTING LONGER THAN 20 MINUTES. TEST MUST BE TAKEN WITHIN A 24 HOUR PERIOD PRIOR TO YOUR APPOINTMENT TIME / DATE. SAME DAY TESTS ARE ACCEPTED, AS ARE HOME TESTS. Thank you for helping keep us all from spreading illnesses. If you plan on wearing a facemask instead, please take a photo of your mask so that way we know. Photos do not automatically upload, please CLICK THE BLUE BUTTON THAT SAYS: “PLEASE UPLOAD IMAGE” in order to move on to the next question.
Previous
Next
Submit
Press
Enter
9
I acknowledge that I must wear a mask vaccinated or not, if I do not take a covid test.
*
This field is required.
Previous
Next
Submit
Press
Enter
10
I understand that this business has the right to ask me to reschedule my appointment based on my responses to these questions.
*
This field is required.
Previous
Next
Submit
Press
Enter
11
I acknowledge by signing this agreement that I have been given the full opportunity to ask any and all questions which I might have about the obtaining of a tattoo and that all of my questions have been answered to my full satisfaction. I specifically acknowledge I have been advised of the facts and matters set forth below and I agree as follows
*
This field is required.
Please contact us with any questions you may have!
Previous
Next
Submit
Press
Enter
12
If I have any condition that might affect the healing of this tattoo, I will advise my tattoo artist. I am not pregnant or nursing. I am not under the influence of alcohol or drugs. I understand that the studio can & will ask me to leave if I appear OR smell of alcohol, marijuana, or other substance AND I WILL BE FINANCIALLY RESPONSIBLE FOR PAYING THE FULL AMOUNT OF TIME OF MY SCHEDULED APPOINTMENT.
*
This field is required.
Previous
Next
Submit
Press
Enter
13
I do not have medical or skin conditions such as but not limited to: acne, scarring (Keloid) eczema, psoriasis, freckles, moles or sunburn in the area to be tattooed that may interfere with said tattoo. If I have any type of infection or rash anywhere on my body, I will advise my tattoo artist.
*
This field is required.
Previous
Next
Submit
Press
Enter
14
I acknowledge it is not reasonably possible for the representatives and employees of this tattoo shop to determine whether I might have an allergic reaction to the pigments or processes used in my tattoo, and I agree to accept the risk that such a reaction is possible.
Previous
Next
Submit
Press
Enter
15
I acknowledge that infection is always possible as a result in obtaining a tattoo, particularly in the event that I do not take proper care of my tattoo. I have received aftercare instructions and I agree to follow them while my tattoo is healing. I agree that any touch-up work needed, will be done at my own expense.
*
This field is required.
You will be directed to the aftercare page on our website automatically once this form is filled out. You can also visit it at any time by going to
https://www.theauracreativestudio.com/aftercare
.
Previous
Next
Submit
Press
Enter
16
I acknowledge that I am responsible for purchasing my own aftercare. If the studio offers this to buy, I may purchase it in addition to the total amount due at the end of my tattoo session.
*
This field is required.
Types of aftercare we offer: Hustlebutter, MadRabbit, & SaniDerm
Previous
Next
Submit
Press
Enter
17
I understand that I have been advised on how to care for my tattoo and upon leaving the studio, I am fully accountable of proper care and healing of the tattoo and understand that if I do not remember, I will text my artist or visit www.theauracreativestudio.com/aftercare.
*
This field is required.
Previous
Next
Submit
Press
Enter
18
I realize that variations in color and design may exist between any tattoo as selected by me and as ultimately applied to my body. I understand that if my skin color is dark, the colors will not appear as bright as they do on lighter skin tones.
*
This field is required.
Previous
Next
Submit
Press
Enter
19
I understand that if I have any skin treatments, laser hair removal, plastic surgery or other skin altering procedures, it may result in adverse changes to my tattoo.
*
This field is required.
Previous
Next
Submit
Press
Enter
20
I acknowledge that a tattoo is a permanent change to my appearance and that no representations have been made to me as to the ability to later change or remove my tattoo. To my knowledge, I do not have a physical, mental or medical impairment or disability which might affect my well being as a direct or indirect result of my decision to have a tattoo.
*
This field is required.
Previous
Next
Submit
Press
Enter
21
I understand that my deposit (if I paid a deposit) will come off the total in the end of my tattoo. If my tattoo is not completed the day of the appointment and must come back for another visit, my deposit may be deducted at that time.
*
This field is required.
Previous
Next
Submit
Press
Enter
22
I understand that if my tattoo artist must make ANY alterations to my art (outside of making my stencil), I must pay for this time.
*
This field is required.
Previous
Next
Submit
Press
Enter
23
I acknowledge that my tattoo ESTIMATE is not exact and can be more or less, depending on the actual amount of time it takes to complete my art work. I know I am responsible for the time it takes to tattoo me.
*
This field is required.
Previous
Next
Submit
Press
Enter
24
I ACKNOWLEDGE THAT THE QUOTE GIVEN TO ME IS AN ESTIMATE, AND NOT A GUARANTEE OF THE AMOUNT OF TIME IT WILL TAKE TO DO MY TATTOO, THIS INCLUDES: APPLYING MY STENCIL (IF THE ARTIST HAS TO MOVE IT, THIS IS TIME I AM PAYING FOR), PERFORMING THE ACTUAL TATTOO, AND CLEANING MY SKIN UP.
*
This field is required.
Previous
Next
Submit
Press
Enter
25
I acknowledge that a tip is not included in the total hourly rate.
*
This field is required.
Tipping is not required, but is greatly appreciated!
Previous
Next
Submit
Press
Enter
26
I am over the age of eighteen and I have presented proof of this to to my tattoo artist. Receiving this tattoo is my choice alone. I consent to the application of the tattoo and to any actions or conduct of the representatives and employees of the tattoo shop reasonably necessary to perform the tattoo procedure. (Washington State Law prohibits ANYONE under the age of 18 years of age to get tattooed)
*
This field is required.
Previous
Next
Submit
Press
Enter
27
I grant Aura Creative, Inc. to use my likeness in photographs & videos in any way the company sees fit including social media and the website. By signing this release, I accept that photographs may be used on the internet or in any other print or electronic media / internet, etc. that Aura Creative, Inc. chooses. I will make no monetary or other claim against Aura Creative, Inc. for use of the photographs or video taken while I am in their studio; or any event Aura Creative, Inc. sponsors or presents.
*
This field is required.
Previous
Next
Submit
Press
Enter
28
I accept any and all charges Aura Creative, Inc. runs on my credit card; or debit card. The total was presented to me prior to handing over my card. My artist will explain all charges PRIOR to running my payment method.
*
This field is required.
Previous
Next
Submit
Press
Enter
29
I agree that I understand that anytime, when I book a tattoo now or in the future, if I need to reschedule or cancel my appointment I MUST let my artist know ASAP, with a minimum of 72 hours prior to my start time, otherwise my artist reserves the right to charge 50% - 100% of the time I had booked, including my deposit. I understand that by not providing sufficient notice - my artist can not make income for reserving this time for me.
*
This field is required.
Exceptions are made in regards to COVID-19. If you have any questions or concerns please contact us ASAP!
Previous
Next
Submit
Press
Enter
30
I acknowledge that I will be allowed into the studio ONLY when I am clean, free of drugs, and free of alcohol. I understand that I must respect EVERYONE in the studio, including Aura Creative, Inc. employees, owners and ALL it’s clients. By being in the studio, I will be respected; as will my time, and should someone call asking for me, Aura Creative, Inc. and it’s employees reserves the right to refuse to offer such information, for the privacy and safety of it’s clients. I understand that if I do not respect these simple rules, I will be asked to leave for an extended amount of time, decided by the ownership.
*
This field is required.
Previous
Next
Submit
Press
Enter
31
I acknowledge that I will behave in a civilized manner. I understand that I am allowed to disagree with ownership and employees, but I will express this in a polite way. My artist has the right to reschedule or cancel my appointment, same day, should they decide that they can not work with me, based on my attitude and treatment of them. If my artist asks me to leave, based on my behavior, I will be 100% responsible for the entire appointment that day..
*
This field is required.
Previous
Next
Submit
Press
Enter
32
COVID-19 Assumption of Risk & Waiver of Liability: Aura Creative Studio ("The Tattoo Studio") has put in place preventative measures to reduce the spread of COVID-19; however; the tattoo studio can not guarantee that you will not become infected with COVID-19. Further, getting tattooed could increase your risk of contracting COVID-19.
*
This field is required.
Previous
Next
Submit
Press
Enter
33
COVID-19 Assumption of Risk & Waiver of Liability: By signing and agreeing to this, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk I may be exposed to or infected by COVID-19 by leaving my home and coming to Aura Creative Studio, and such exposure or infection may result in personal injury, illness, permanent disability, or death.
*
This field is required.
Previous
Next
Submit
Press
Enter
34
COVID-19 Assumption of Risk & Waiver of Liability: By signing and agreeing to this, I acknowledge that I understand that the risk of becoming exposed to or infected by COVID-19 at the tattoo studio may result from the actions, omissions, or negligence of myself and others, including, but not limited to, the studio employees, it’s clients.
*
This field is required.
Previous
Next
Submit
Press
Enter
35
COVID-19 Assumption of Risk & Waiver of Liability: By signing and agreeing to this, I acknowledge that I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself, (including, but not limited to, personal injury, disability, or death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with visiting Aura Creative Studio and Aura Art & Ink.
*
This field is required.
Previous
Next
Submit
Press
Enter
36
COVID-19 Assumption of Risk & Waiver of Liability: By signing and agreeing to this, I acknowledge that I hereby release, covenant not to sue, discharge, and hold harmless the tattoo studio, it's owner, artist, employees or other clients at Aura Creative Studio , agents of either business and its representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of relating thereto.
Previous
Next
Submit
Press
Enter
37
COVID-19 Assumption of Risk & Waiver of Liability: By signing and agreeing to this, I acknowledge that I understand and agree that this release includes any Claims based on the actions, commission's, or negligence of the business & its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after visiting for an appointment or other visit.
*
This field is required.
Previous
Next
Submit
Press
Enter
38
IF YOU HAVE READ THIS FORM IN ITS ENTIRETY AND AGREE TO EVERYTHING, PLEASE TYPE YOUR FULL NAME HERE.
*
This field is required.
YOUR FULL NAME
Previous
Next
Submit
Press
Enter
39
Today's Date
*
This field is required.
-
Date
Month
Day
Year
1
2
3
4
5
6
7
8
9
10
11
12
6
1
2
3
4
5
6
7
8
9
10
11
12
Hour
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
49
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
Minutes
AM
PM
PM
AM
PM
Previous
Next
Submit
Press
Enter
40
Date & Time of scheduled appointment with us.
*
This field is required.
-
Date
Month
Day
Year
1
2
3
4
5
6
7
8
9
10
11
12
1
2
3
4
5
6
7
8
9
10
11
12
Hour
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
Minutes
AM
PM
PM
AM
PM
Previous
Next
Submit
Press
Enter
41
I have read the terms and conditions.
*
This field is required.
Previous
Next
Submit
Press
Enter
42
Signature
*
This field is required.
For best results - turn your smart device sideways.
Clear
Previous
Next
Submit
Press
Enter
43
ID verification
*
This field is required.
Please take a CLEAR photo of a valid form of identification, taking up the entire width and length of your camera. Please remember you must have a valid ID (no expired forms accepted). Valid forms include : Driver's Licenses, State Issued Identification, Military ID, other government issued ID with a photo AND date of birth. Please remember you MUST have turned 18 on the day of or prior to your tattoo appointment, even with parental consent.
Drag and drop files here
Select files to upload
Browse Files
Cancel
of
Previous
Next
Submit
Press
Enter
Should be Empty:
2024 Tattoo Consent Form
[Edit]
Question Label
1
of
43
See All
Go Back
Submit