Tattoo Consent/Liability Form

Jade Foxx Tattoo Consent Form

and Liability Waiver
*THIS IS A HEAFTY FORM, PLEASE ENSURE YOU HAVE READ AND SIGNED EVERYTHING*
Name
Legal name if different
Pronouns
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth

MonthDayYear
Must be 18 or older at time of appointment.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Any other access needs or allergies
i.e. lighting/noise level adjustments, prefer not to talk, experiencing body pain, low energy, trauma triggers etc.
I acknowledge by signing this agreement that I have been given the full opportunity to ask any and all questions which I might have about obtaining a tattoo and that all of my questions have been answered to my full satisfaction. I specifically acknowledge I have been advised of the facts and matters set forth below in consideration of receiving a tattoo from “Jade Foxx”, (hereafter referred to as the “Tattoo Artist”) I agree to the following:

I have been fully informed of the inherent risks associated with getting a tattoo. I fully understand that these risks, known and unknown, can lead to injury, including but not limited to infection, scarring, difficulties in the detection of melanoma, and allergic reactions to tattoo pigment and/or soap. Having educated myself on the potential risks associated with getting a tattoo, I still wish to proceed with the tattoo procedure and application, and freely accept & expressly assume any & all risks that may arise from tattooing.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. The Tattoo Artist has given me aftercare instructions and I agree to follow them while my tattoo is healing. I agree that any touch-up work needed, due to my own negligence or failure to follow such instructions, will be done at my own expense.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 my skin colour is dark, the colours will not appear as bright as they do on light skin. I understand that if I have any skin treatments, laser hair removal, plastic surgery or other skin-altering procedures, it may result in adverse changes to my tattoo.I do not have any medical or skin conditions that may interfere with the procedure, application or healing of the tattoo. This may include, but is not limited to: diabetes, epilepsy, hemophilia, or any heart conditions. I do not take medication that thins my blood. I am not the recipient of an organ or bone marrow transplant or, if I am, have taken the prescribed preventative regimen of antibiotics that my doctor requires in advance of any invasive procedure such as tattooing.
By filling out this agreement I grant permission for my photos to be taken on the date of my appointment.
- 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 the use of the photographs. I understand that my name may or may not be included/credited in any form of publication unless requested otherwise.
- If I choose not to have my photo taken I will inform the Tattoo Artist.
This is how my artist may use my photo:
Covid-19 Screening questions
Please check if you have experienced any of the following in the last 14 days
Have you been in touch with a known or suspected COVID patient or anyone experiencing the above symptoms?
If Yes, or Maybe please provide a brief description:
Have you traveled outside of British Columbia in the last 30 days? This includes traveling out of your home state to attend your appointment.
Please read the following and sign to acknowledge:
- No guests will be allowed unless needed for accessibility reasons, to limit the total number of people in the studio at a time.
- If you would like to wear a mask to your appointment, please inform your artist if you would like them to do the same.
- Please bring a snack and water bottle to your appointment, to limit the exchange of objects between us.
- 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.
I attest that:
- I am not experiencing any symptoms 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 travelled internationally within the last 14 days.
- I have not travelled to a highly impacted area within Canada 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 have been 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 WAIVE AND RELEASE to the fullest extent permitted by law any person of the Tattoo Artist from all liability whatsoever, including but not limited to; any and all claims or causes of action that I, my estate, heirs, executors or assigns may have for personal injury or otherwise, including any direct and/or consequential damages, which result or arise from the procedure and application of my tattoo, whether caused by the negligence or fault of either the Tattoo Artist, or otherwise.
Signature
Should be Empty:

Jade Foxx Tattoo Consent Form

Covid-19 Screening questions