TATTOO CONSENT FORM

TATTOO CONSENT FORM

Please check all boxes provided after reading to show that you understand each provision. Feel free to ask any questions regarding this waiver.
Full Name shown on ID

First NameLast Name
Today’s date

MonthDayYear
Date
Age
Are you under the influence of drugs or alcohol?
Are you pregnant or nursing?
Do you have a communicable disease/blood borne virus?
Do you take any prescribed medication regularly (especially any anticoagulants such as warfarin aspirin immuno-suppressants such as steroids)?

Other
Do you suffer from diabetes, epilepsy, hemophilia, heart conditions?

Other
Do you allow your tattoo to be photographed and used for the Tattoo Shop portfolio?
I, blanks (full name) fully understand the inherent risk associated with getting a tattoo. I wish to proceed with the tattoo procedure and application and greedily accept and expressly assume any risk that may arise from tattooing.
Please read and check each question
I have read the agreement, I understand it, and agree to be bound by it. Signature :
Picture of your ID

Cancelof
Should be Empty: