Tattoo Consent Form
  •  Licensed tattoo artist 

    Address will be provided same day as appointment.

    Chelly : +1 347-943-4832  
     

  • Client Information

    Please fill out the information below to the best of your knowledge
  • Date of Birth*
     - -
  •  -
  • Health Questionnaire

    Please select all that apply to you
  • Do you have any allergies such as:*

  • Diseases:*

  • Overall Health*

  • Acknowledgment and Waiver

    By completing and signing this form, I acknowledge that I have been given the full opportunity to ask any and all questions which I might have about obtaining a tattoo from Dick's Tattoo Parlor, and that all of my questions have been answered to my full and total satisfaction. I specifically acknowledge that I have been advised of the facts and matters set forth, and I agree as follows:
  • Signed Date*
     - -
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  • If you have any questions, feel free to call,text, or email me at chelly.l@icloud.com or @chellyworldink /@Thaturbanchick

    Text me at +1 347-943-4832

    get ahold of me on IG or through email/phone.

    Thanks, ChellyWorldInk

                                    

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