Tattoo Consent Waiver

SharkTooth Tattoo Consent Waiver
Client Information
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Phone Number*
Email*
example@example.com
Gender*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Type of VALID identification:*
Upload a photo of your ID:*

Cancelof
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.
About Today's Session
Today's Date*

MonthDayYear
Date
Artist*
I, Full Name*, hereby acknowledge that I have been informed and understand that my tattoo will be performed by an apprentice under the supervision of a licensed tattoo artist. I confirm that I have had the opportunity to ask questions regarding the procedure and the qualifications of the apprentice, and I accept the risks associated with receiving a tattoo from an apprentice. By signing this waiver, I consent to the tattooing process as outlined above, and I release SharkTooth Tattoo & Gallery and its employees from any liability related to this procedure.
Tattoo Description*
Tattoo Placement*
Medical History

We ask these questions to assure a safe and healthy session for everyone. We respect your privacy and will protect your health information.
Select any that apply.
Allergies*

AntibioticsMetalsSoapsLatexAlcoholAdhesivesPetroleumLanolin OilShellfishCosmeticsNONEOther
Diseases*

HepatitisTuberculosisGonorrheaSyphilisHerpesHIV/AIDSStaphNONEOther
Health Conditions*

Heart DiseaseHigh Blood PressureDiabetesPregnantProne to FaintingSkin LesionsEpilepsyHemophiliaProne to ScarringPsoriasisEczemaNarcolepsySeizuresNONEOther
Additional Health Information*
If none, write N/A.
How long since you last ate?*
Medication
Are you currently taking any blood thinning medication?*

YesNo
Are you currently taking any medications?*
If yes, then please specify it on the field above.
Tattoo Consent Waiver Agreement
By checking the boxes below, I First Name* Last Name* confirm that I have read, understood and agree to the following:
I have truthfully represented to SharkTooth Tattoo & Gallery that I am 18 years of age or older.I am voluntarily choosing to receive a tattoo from SharkTooth Tattoo & Gallery and understand that this procedure involves the application of permanent ink into my skin.I am not under the influence of alcohol or drugs.I understand no technician shall perform body art procedures on any individual who appears under the influence of alcohol, controlled substances, or hazardous substances.I confirm that I do not have any medical conditions, including but not limited to allergies, skin conditions, or infections, that could interfere with the tattooing process or healing. I have disclosed any and all relevant medical information in this form to the best of my knowledge.I am not pregnant or nursing.I understand that there are potential risks associated with tattooing, including but not limited to infection, scarring, allergic reactions, and dissatisfaction with the final result. I accept these risks and agree not to hold SharkTooth Tattoo & Gallery or its artists liable for any complications that may arise.I understand a tattoo is considered permanent and may only be removed with a surgical procedure that may leave scarring.I acknowledge that proper aftercare is crucial for the healing of my tattoo. I have received and understood the aftercare instructions provided by SharkTooth Tattoo & Gallery and agree to follow them diligently.I agree that any touch-up work needed, due to my own negligence, will be done at my own expense. This includes sun and UV frequency damage.I have reviewed and approved the design and placement of the tattoo. I understand that any changes to the design after the start of the tattooing process may not be possible.I acknowledge that if my tattoo is a symbol, or something written in a language other than English, SharkTooth Tattoo & Gallery or its artists are not responsible for what it may or may not mean.I acknowledge that if my tattoo includes text that I am responsible for the correct spelling, grammar and punctuation. I have proofread the text before it has been applied as a tattoo.I agree to IMMEDIATELY notify the artist if I feel lightheaded, dizzy, and/or faint before, during or after the tattoo procedure. Failure to do so releases SharkTooth Tattoo & Gallery and my artist of all responsibility.
By initialing the statements below, I confirm I have read, understood, and agree to the following:

Initial Here*   I have truthfully represented to SharkTooth Tattoo & Gallery that I am 18 years of age or older.

Initial Here*   I am voluntarily choosing to receive a tattoo from SharkTooth Tattoo & Gallery and understand that this procedure involves the application of permanent ink into my skin.

Initial Here*   I am not under the influence of alcohol or drugs.

Initial Here*   I understand no technician shall perform body art procedures on any individual who appears under the influence of alcohol, controlled substances, or hazardous substances.

Initial Here*   I confirm that I do not have any medical conditions, including but not limited to allergies, skin conditions, or infections, that could interfere with the tattooing process or healing. I have disclosed any and all relevant medical information in this form to the best of my knowledge.

Initial Here*   I am not pregnant or nursing.

Initial Here*   I understand that there are potential risks associated with tattooing, including but not limited to infection, scarring, allergic reactions, and dissatisfaction with the final result. I accept these risks and agree not to hold SharkTooth Tattoo & Gallery or its artists liable for any complications that may arise.

Initial Here*   I understand a tattoo is considered permanent and may only be removed with a surgical procedure that may leave scarring.

Initial Here*   I acknowledge that proper aftercare is crucial for the healing of my tattoo. I have received and understood the aftercare instructions provided by SharkTooth Tattoo & Gallery and agree to follow them diligently.

Initial Here*   I agree that any touch-up work needed, due to my own negligence, will be done at my own expense. This includes sun and UV frequency damage.

Initial Here*   I have reviewed and approved the design and placement of the tattoo. I understand that any changes to the design after the start of the tattooing process may not be possible.

Initial Here*   I acknowledge that if my tattoo is a symbol, or something written in a language other than English, SharkTooth Tattoo & Gallery or its artists are not responsible for what it may or may not mean.

Initial Here*   I acknowledge that if my tattoo includes text that I am responsible for the correct spelling, grammar and punctuation. I have proofread the text before it has been applied as a tattoo.

Initial Here*   I agree to IMMEDIATELY notify the artist if I feel lightheaded, dizzy, and/or faint before, during or after the tattoo procedure. Failure to do so releases SharkTooth Tattoo & Gallery and my artist of all responsibility.

Initial Here*   The technician shall not perform a body art procedure if the client fails to complete or sign the disclosure and authorization form, and the technician may decline to perform a body art procedure if the client has any health conditions.
Signature*

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SharkTooth Tattoo Consent Waiver

Client Information

About Today's Session

Medical History

Medication

Tattoo Consent Waiver Agreement

By initialing the statements below, I confirm I have read, understood, and agree to the following: