TATTOO CONSENT FORM

TATTOO CONSENT FORM

Jazmyn Proud working out of No Morals Limited trading as NMT of 54 Leys Avenue, Letchworth, Hertfordshire, SG6 3EQ.
Name*

First NameLast Name
Date of Birth *
Age*
Identification *
Address*
Phone number*
Email*
example@example.com
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MEDICAL HISTORY

Please answer truthfully, providing details when prompted.
Heart conditions *
Please provide further information including the medical condition, any treatment and medication requirements *
Skin conditions including eczema, impetigo, psoriasis, & acne *
Please provide information including the skin condition, location on body, any treatment & medication requirements.*
Communicable diseases e.g Hepatitis *
Please provide information including the medical condition, any treatment and medication requirements *
Medical conditions that may cause haemorrhaging e.g Haemophiliac *
Please provide information including the medical condition, any treatment and medication requirements *
Diabetes *
How do you control your diabetes '*
Have you been hospitalised in the past 6 months as a result of your diabetes?*
Is your diabetes under control *
Please provide further information *
Epilepsy *
Please provide information including the medical condition, any treatment and medication requirements *
Seizures *
Please provide information including the medical condition, any treatment and medication requirements *
Allergies e.g good (inc nuts), plasters, jewellery metals, skin care products *
Please list the items you are allergic to. *
Are you Pregnant or Breast Feeding? *
Blood pressure *
Do you control it with medication *
Is it under control *
Please provide further information *
Fainting *
Please provide further information *
Steroids *
Please provide further information *
Autoimmune disease*
Please provide information including the medical condition, any treatment & medication requirements
Cancer, Leukemia or Lymphoma*
Please provide information including the medical condition, any treatment & medication requirements*
Have you had Covid-19 within the past 3 months? *
Have you had surgery within the last 3 months or, do you have any operations pending *
Please provide further information *
Do you have any other medical conditions not listed *
Please provide information including the medical condition, any treatment & medication requirements*
Are you currently under the influence of alcohol or drugs?*

I fully understand that I must be 18 years of age and over to be tattooed and I am fully aware of theirreversible nature of the service to be provided. I hereby certify that I have truthfully represented to Jazmyn Proud and representatives, working out of No Morals Limited trading 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 Jazmyn Proud working out of NMT reasonably necessary to perform the tattoo procedure.

I understand that Jazmyn Proud 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 Limitedtrading 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 Jazmyn Proud working out of No Morals Limited trading 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 alsounderstand 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 Jazmyn Proud, No Morals Limited trading 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 asultimately applied to my body.

I understand that using numbing agents prior to my appointment, against the advice of Jazmyn Proud, 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, Jazmyn Proud and No Morals Limited trading 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 a hand tattoo.

I understand that the outcome of the tattoo is entirely dependent on my following of the aftercare and that Jazmyn Proud and No Morals Limited trading as NMT cannot be held accountable or responsible for this.

I agree to follow the aftercare instructions provided to me, along with the products, in my aftercare pack. I understand the aftercare will be given verbally, as literature and a copy sent to the email address 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 Jazmyn Proud is required to take pictures before and after of the treatment areas, and I permit them to be used on social media by Tom Johnson and No Morals Limited trading as NMT. Should I wish to revoke permission for their use in the future, I understand that I must notify Jazmyn Proud in writing and allow 30 days to accomplish this removal.

I agree to release and forever discharge and hold harmless, Jazmyn Proud, No Morals Limited trading 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 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 Jazmyn Proud working out of No Morals Limited trading 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 Jazmyn Proud working out of No Morals Limited trading 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.
Signature
Print name
Date

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ARTIST USE ONLY
Tattoo design *
Signed picture of script stencil

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Tattoo location *
Side of body *
Picture of completed tattoo

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Aftercare *
Signature
Print name *
Date*

MonthDayYear
ADDITIONAL NOTES
ADDITIONAL UPLOADS

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Should be Empty:

TATTOO CONSENT FORM

MEDICAL HISTORY

ARTIST USE ONLY