Tattoo & Body Piercing Procedure Waiver
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number '
*
Please enter a valid phone number.
Format: (000) 000-0000.
The date of my appointment is…
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
This was a…
Please Select
Walk-in
Appoinment
Your Artist- please select below
*
Please Select
Jenna Noble
Matias Pefaur
Michael Barajas
Xin Truong
Brennan Carter
Joey Doyle
Caleb Smith
Cost of tattoo:
*
Please read and mark that you understand the following statments.
I understand that this is a binding contract with NobleTats Tattoo Studio & I have been given full opportunity to ask any and all questions about my procedure. All of my questions have been answered to my satisfaction. I understand that my procedure may be permanent, and may require surgical procedure for removal. I am aware that removal may cause scarring.
*
I agree to this statement
I do not have any medical conditions or communicable diseases (including but not limited to diabetes, epilepsy, hemophilia, hepatitis, HIV, AIDS, tuberculosis, COVID19). I do not have a skin condition that may interfere with the proper healing of my procedure (including but not limited to acne, scarring or keloids, eczema, psoriasis, freckles, moles, or sunburn). I am not pregnant or nursing. I have informed the agent of NobleTats Studio and documented below of any exceptions to the above. I am not under the influence of drugs, alcohol, or any narcotic, including but not limited to prescription pharmaceuticals, & over the counter medications. I am aware that being under the influence can have an adverse effect on the procedure. I agree that Tattoo Studio cannot determine if I will have an allergic reaction to any of the products used to complete my procedure. I attest that I have no known allergies, or if I do I have documented them on the back of this form and alerted the agent of NobleTats Studio.
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I agree to this statement
I am aware of the possibility of infection with my procedure. I understand that when I leave the premises of NobleTats Studio, my procedure is only half complete. It is my responsibility to follow the aftercare procedures recommended by NobleTats Studio. NobleTats Studio makes no claim to the success or validity of the recommended aftercare procedures, they are simply guidelines. I agree to not hold NobleTats Studio liable for any necessary touch-up work cause by my own negligence. I understand that skin color will have an effect on the final result of my tattoo. I agree to leave the premises of NobleTats Studio or any other location where NobleTats Studio is engaged in business promptly upon request, for any reason whatsoever, by any employee or agent of NobleTats Studio.
*
I agree to this statement
Today's Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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