• The Sacred Heart Tattoo Consent Form

    and COVID-19 Liability Waiver
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  • I acknowledge I have been advised of the facts and matters set forth below and I agree as follows:

    • If I have diabetes, epilepsy, hepatitis, hemophilia, HIV-AIDS or any other communicable disease, heart condition or take medicine which thins the blood I have advised my tattooer.
    • I am not pregnant or nursing. I am not under the influence of alcohol or drugs.
    • I acknowledge it is not 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.
    • I acknowledge that infection is always possible as a result of the obtaining of a tattoo, particularly in the event that I do not take proper care of my tattoo. I agree to follow aftercare instructions while my tattoo is healing. 
    • 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 I have any skin treatments, laser hair removal, cosmetic surgery or other skin altering procedures, it may result in changes to my tattoo.
    • I acknowledge that a tattoo is a permanent change to my appearance and do not hold my tattooer liable for or of the ability to later change or remove my tattoo. 
    • I acknowledge I am over the age of eighteen and that I have truthfully represented to my tattooer that the obtaining of a tattoo is by my choice alone. 
    • I fully understand the tattoo artist does not act as a medical professional. 
    • I agree to release and discharge my artist from any and all claims, damages, or legal actions arising from or connected to my tattoo and the procedure used in the application of my tattoo.
    • I consent to the application of the tattoo. My tattoo artist and I recognize that I may revoke this consent at any time before or during the tattoo procedure.
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  • By filling out this agreement I grant permission for my photos to be taken on today’s date.

    • I understand that photographs taken of me during this session may be used, wholly or in part, on the internet, in any publication, portfolio, or display, or in any other print or electronic medium as this artist chooses, unless otherwise specified below.
    • I confirm I am 18 years of age or older. I will make no monetary or other claim against this artist for use of the photographs. I understand that my name may or may not be included/credited in any form of publication unless requested otherwise.
  • Covid-19 Screening questions

  • Please read the following and sign to acknowledge:

    • Your temperature will be taken when you arrive with a contactless thermometer. If over 100.3F, you will be rescheduled
    • No guests will be allowed unless needed for accessibility reasons, to limit the total number of people in the studio at a time. 
    • Appointment start times will be staggered compared to other artists so that clients do not arrive at the same time. The waiting area of the studio will be disinfected in-between clients. All artists will be wearing masks when within 6 feet of other people.
    • You will be asked to wash your hands or use sanitizer upon arrival. We will disinfect your phone for you or place it into a plastic bag.
    • Please wear a mask to your appointment. If you do not have access to a mask, please let me know and I will have one waiting for you. 
    • Please bring your snack, and water bottle to your appointment, to limit exchange of objects between us. We will have snacks and water still if you forget! 
    • You will be asked to sanitize your hands if you need to remove your mask for a water or snack break.
    • If you test positive for COVID-19 within 14 days of your appointment, please alert your artist so that our post-exposure plan may be put into effect.
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  • Covid-19 Liability Waiver

  • I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing.
    I further acknowledge that The Sacred Heart Tattoo and my artist has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.
    I further acknowledge that The Sacred Heart Tattoo and my artist can not guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to staff, and other clients and their families.
    I voluntarily seek services provided by The Sacred Heart Tattoo and my artist and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending my appointment.
    I attest that:
    * I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.
    * I have not traveled internationally within the last 14 days.
    * I have not traveled to a highly impacted area within the United States of America in the last 14 days.
    * I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.
    * I have not been diagnosed with Coronavirus/Covid-19 and not yet cleared as non contagious by state or local public health authorities.
    * I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19.
    I hereby release and agree to hold The Sacred Heart Tattoo and my artist harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of the studio, or that may otherwise arise in any way in connection with any services received from The Sacred Heart Tattoo and my artist. I understand that this release discharges The Sacred Heart Tattoo and my artist from any liability or claim that I, my heirs, or any personal representatives may have against the studio with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from The Sacred Heart Tattoo and my artist. This liability waiver and release extends to the studio together with all owners, partners, and employees.

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