Tattoo Consent Form

Please complete this ON THE SAME DAY of your tattoo booking, before you come to the studio, as we need up to date information.

Data Protection: The information you provide us with will not be shared with third parties, it will be stored in a secure place and will be destroyed in compliance with data protection laws.

Legal Name:*

First NameLast Name

Date Of Birth:*

Date

Pronouns:

Phone Number:*

Please enter a valid phone number.Format: 00000000000.

Email:*

example@example.com

Address:*

Street Address

Street Address Line 2

CityCounty

Postal / Zip Code

Emergency Contact Name:*

First NameLast Name

Emergency Contact Phone Number:*

Please enter a valid phone number.Format: 00000000000.

Relationship To You:*

Valid PassportValid Drivers LicenseValid Provisional License

Medical History

Rows	Yes	No
High Blood Pressure
Diabetes
Heart Disease
Epilepsy
Psoriasis
Metal Allergy
Low Blood Pressure
Heart Murmur
Impetigo
Adhesive Bandage or Plaster Allergy
History Of Haemorrhaging
Hepatitis
Pacemaker
Eczema
Latex Allergy
Long Covid
Cancer

Do you have any allergies not listed above?

YesNo

If yes then please detail below:

YesNo

Is there anything I can do to provide to help make your experience better? (For example- Bringing a friend, headphones, screens etc...)

If yes, please identify the condition.

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 realise 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.

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.

Use my images on social networks, publications, portfolios and or displays.Keep my images private, do not share with anyone.Do not take my photo

No tattoo can be 100% perfect, but I will always try my best to meet your expectations. All skin is different, and this can be reflected in the healing process, especially on the hands, fingers, wrists, feet, elbows, knees and ankles. The first touch up is free within the first year, any subsequent touch ups will have a minimum charge.

I hereby declare that I am of legal age and I am competent to sign this agreement or, if not, my parent or legal guardian should sign on my behalf, and that my parent or guardian is in complete understanding and concurrence with this agreement. I also understand that each tattooer/piercer that operates from the The Last Nail Tattoo premises represents themselves only as an individual sole traders & is self employed.

Signature*

Todays Date*

Date