Tattoo consent form

Tattoo consent form

Laura Mercy (Gelder) working out of No Morals Limited trading as NMT- 54 Leys Ave, Letchworth, Hertfordshire, SG6 3EQ
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

City County

Postcode
Phone number *
Email address *
Date of birth *

DayMonthYear
Date
Age *
Please upload ID- between 2001-2008. Please upload a selfie or ID after 2001 to prove that it’s you filling out the form. *

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FemaleMaleNon BinaryPrefer not to say
Emergency contact name *

First NameLast Name
Emergency contact number*

MEDICAL HISTORY

Please answer to the best of your knowledge
Heart conditions e.g pacemaker *
Skin conditions including eczema, impetigo, psoriasis or acne*
Do you suffer from keloids?*
Communicable diseases e.g Hepatitis *
Medical conditions that may cause haemorrhaging e.g Haemophilia *
Are you on any blood thinner medication? *
Diabetes*
Epilepsy *
Seizures *
Allergies e.g food, plasters/micropore tape , jewellery metals or skin care products *
Have you had a reaction to second skin or inks previously?*
Pregnant or breastfeeding *
Blood pressure*
Fainting *
Last time fainting*
Steroids *
Autoimmune disease *
Cancer, Leukaemia or Lymphoma *
Radiotherapy or chemotherapy *
Covid symptoms or had Covid in the last 3 months *
Had any surgery within the last 3 months or any pending operations?*
Do you take any current medication? *
Are you under the influence of drugs? *
Have you used numbing cream?*
If answering yes to any of these questions, please make note of medication/s and any details of the condition. Anything medically relevant that needs to be stated/ allergies that have been mentioned.*
Have I asked you for a doctors note? *
Doctors note upload

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Tattoo design brief
I am aware that this information is correct, I will tell Laura if anything may be wrong with my design. I will voice any concerns regarding the design or tattoo placement when the stencil is applied. I take full responsibility if the placement isn’t correct. I understand by signing this form, the dates and names that I have given are correct. I take full responsibility for anything that is spelt wrong or if have given the wrong date/s. Laura Mercy (Gelder) is relieved of this mistake and will charge to fix any mistakes done from this answer.*

Yes
Tattoo design*
It can be brief
Names, dates or script that you are getting, if applicable. (Please make sure these are spelt right and the date is correct) *
Tattoo placement *

Important polices
I fully understand that I must be 18 years of age and over to be tattooed and I am fully aware of the irreversible nature of the service to be provided. I hereby certify that I have truthfully represented to Laura Mercy (Gelder) and representatives, working out of No Morals Ltd t/as NMT that I am 18 years of age and over for a tattoo. I acknowledge that obtaining my tattoo is my choice alone and I consent to the application of the tattoo and to any actions or conduct of Laura Mercy (Gelder) working out of No Morals Ltd t/as NMT reasonably necessary to perform the tattoo procedure.

I understand that Laura Mercy (Gelder) is undertaking my work and is self-employed. Therefore, all complaints, questions and/or queries must be referred directly back to her. I cannot and will not hold No Morals Ltd t/as NMT responsible for the undertaking, results, or any incidents that may occur as a result of her work.

I acknowledge that it is not reasonably possible for Laura Mercy (Gelder) working out of No Morals Ltd t/as NMT to determine whether I might have an allergic reaction to the dyes, metals, pigments, recommended aftercare, tattoo related products or processes used in my tattoo, and I agree to accept that this risk is a possibility.

I acknowledge that if I have declared a metal allergy, I have been offered a skin test to indicate any potential reaction and understand, as stated above, that an allergic reaction may be a result of this. I also understand that a skin test does not mean that I will not have a reaction to the dyes, metals or pigments used.

I acknowledge that it is of my own choosing to undertake a session and should I elect to finish the session early, or faint, or be unable in any way to continue with the session, I will still be liable for the remaining cost of the appointment.

I acknowledge and understand that the obtaining of a coverup does not guarantee that the old tattoo will be disguised by the new one and that the success of a coverup is individual to each person and the aftercare process followed. I understand that the success of a coverup is not guaranteed.

I acknowledge that I need to remain still and I understand that any sudden or unexpected movements made may result in a change to the tattoo that may then need to be rectified and cause a variance in the design. I cannot hold Laura Mercy (Gelder),No Morals Ltd t/as NMT, its employees, and representatives responsible.

I acknowledge that a variation in colour and design may exist between any tattoo selected by me and as ultimately applied to my body.

I understand that using numbing agents prior to my appointment, against the advice of Laura Mercy (Gelder), may result in my appointment being terminated and I will remain liable for the full cost of the appointment. If numbing agents are used, despite the above advice, Laura Mercy (Gelder) and No Morals Ltd t/as NMT cannot be held liable for any adverse reactions prior, during, or post tattoo application. I understand that the use of this product type is at my own discretion and consequence and may result in a variation between my planned tattoo and the final result.

I understand that obtaining a tattoo is of my own decision and is a permanent change to my appearance; no representations have been made to me as to the ability to later change or remove my tattoo. I have had the potential complications explained to me and understand that if do not follow the aftercare, these complications have a higher chance of occurring. Examples being, but not limited to, infection and increased/delayed healing process. I understand that touch ups are chargeable and are usually required for nearly all tattoos depending upon circumstances .

I understand that the outcome of the tattoo is entirely dependent on my following of the aftercare and that Laura Mercy (Gelder) and No Morals Ltd t/as NMT cannot be held accountable or responsible for this.

I agree to follow the aftercare instructions provided to me digitally, along with the products I have suggested, and have been sent to me. I understand the aftercare will be given verbally, as literature and a copy sent to the email address/ instagram provided on this form. I agree that any required touch-up work needed will be done at my own expense unless stated otherwise.

I agree that Laura Mercy (Gelder) is required to take pictures before and after of the treatment areas, and I permit them to be used on social media by Laura Mercy (Gelder) and No Morals Ltd t/as NMT . Should I wish to revoke permission for their use in the future, I understand that I must notify Laura Mercy (Gelder) in writing and allow 30 days to accomplish this removal.

I agree to release and forever discharge and hold harmless, Laura Mercy (Gelder),No Morals Ltd t/as NMT, the artists, employees & representatives, from any and all claims, damages or legal actions arising from or connected in any way with my tattoo, aftercare or procedures and conduct used to apply my tattoo.

I acknowledge that if I have used Klarna to pay for the rest of my tattoo that it is my responsibility to pay the remainder of the balance to Klarna personally and I take full responsibility if its not paid. I acknowledge that any problems or questions about my tattoo must only come through Laura Mercy (Gelder) and that Klarna can not help me with a refund or process any concerns. If I make any claims to Klarna, my pre care form, consent form, any messages between myself and Laura Mercy (Gelder) and any photos of the tattoo will be sent to Klarna. I will ensure I will go through Laura Mercy (Gelder) with any problems or questions.

I acknowledge that the information I have provided in this document is accurate and true. By signing this form, I have been given the full opportunity to ask any and all questions which I might have about undergoing the procedure, from Laura Mercy (Gelder) working out ofNo Morals Ltd t/as NMT, and all of my questions have been answered to my full and total satisfaction. I am totally satisfied and agreen to have the procedure carried out by Laura Mercy (Gelder) working out of No Morals Ltd t/as NMT and I have entered into this release freely or voluntarily and I agree to be bound by the matters set forth above thereby.
Date*

DayMonthYear
Date
Hour Minutes
Print name *
Signature

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Tattoo consent form

MEDICAL HISTORY

Tattoo design brief

Important polices