Tattoo Consent Form

Tattoo Consent Form
Client Information
Name *

Client Name (first and last)Artist Name
Birth Date*

MonthDayYear
Date
Email
example@example.com
Phone number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Pre-Procedure Questionnaire/ Health Disclosure

By completing this form I, the client, agree to answer honestly and truthfully and agree to the following statements.
FEMALE ONLY: Are you pregnant or nursing?*

YesNo
Are you under the influence of drugs or alcohol?*

YesNo
I confirm that I do not have any medical conditions (e.g. diabetes, epilepsy, haemophilia, heart conditions, skin conditions, eczema, infection, psoriasis, freckles, blood thinners etc.) that may affect the healing process or put me at risk. I also do not have any cold and flu symptoms. If yes please identify the condition/s you have and discuss with the artist. If none state N/A*
If yes, please identify the condition.
Acknowledgment and Waiver
I am receiving this tattoo voluntarily and understand it is a permanent modification to my skin and body.*

Yes
Risk, hygiene & safety Acknowledgement.*

I understand that getting a tattoo involves risks, including but not limited to infection, allergic reactions, scarring, development of skin conditions, scaring and pain.I release the tattoo artist and studio from any liability related to complications that may arise from my tattooI acknowledge that sterile, single-use equipment is used and that proper hygiene standards are followed.I understand that Savannah Studios operates a no refund policy, with regards to deposits and final payments.I agree that the studio does not have a way of identifying if I am allergic to the elements or ingredients that will be used for my tattoo.
Design and placement approval*

I have reviewed and approved the design, placement, and where applicable, the spelling, date and font of my tattoo.I understand colours and details may vary based on skin type and healing.
Aftercare agreement*

I will and must follow the provided aftercare instructions given following the tattoo process. (Refresher details will be available to me on the Savannah Studios website)I should avoid swimming, sun exposure and picking at the tattoo during the healing process.If I experience any signs of problematic healing (excessive redness, pus, fever) I should speak with the artist.The healing process varies, and touch-ups may be necessary (subject to the studios policy)
Photography & Media consent waiver*

I authorize Savannah studios to take photographs and/or videos of my tattoo before, during and after the tattooing process.These images may be used for promotional purposes, including but not limited to, social media, websites, advertising and portfolios.My identity will be protected where necessary, and images may be cropped or edited for atistic purposes.I waive the rights to compensation for the use of these images.
Consent for media use in promotional purposes*

I CONSENT to the use of my videos/photos for promotional purposesI DO NOT CONSENT to the use of my videos/photos for promotional purposes
Client Signature*
Signed Date*

MonthDayYear
Date
Print name
Should be Empty:

Tattoo Consent Form

Client Information

Pre-Procedure Questionnaire/ Health Disclosure

Acknowledgment and Waiver