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  • Fine Line Tattoo Inquiry Form

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  • Health & Safety

  • Appointment Prefrences

    Please Note: CURRENTLY BOOKING OCTOBER Once you have received your booking deposit invoice- appointments will not be booked until payment is made. if you fail to pay your deposit within 24 hrs your invoice will be cancelled. Shop minimum is $125.
  • Consent Form

  • Blood Borne Pathogens: HBV , HIV , and HCV are all bloodborne pathogens transmitted through contact

    with infected blood and/or bodily fluids. I understand that due to the nature of this cosmetic procedure, I

    may be at risk. With proper PPE precautions made by your practitioner the risk has been significantly

    minimized. In the event exposure has been evident during your procedure both practitioner and client

    MUST pause the procedure and report to the emergency room for infection control and testing. If you are

    a carrier of HBV , HIV , or HCV please notify your practitioner prior to your procedure.

    Uneven Pigmentation: Uneven pigmentation can result from infection, poor healing, inability to follow

    proper after care, pre existing skin conditions, or scar tissue. Results may vary during healing and

    unevenness will be addressed during your follow up appointment.

    Pain or Discomfort: Tattooing is the practice of implanting pigment into the skin to create art.. You may experience

    minor discomfort or pain during this procedure and symptoms may linger even after the procedure is complete.

    Infection: Infection is unusual for cosmetic tattoo procedures. Treated areas must be kept clean, only to use provided

    aftercare, and use clean hands when touching the treatment area. It is imperative you follow your Artists aftercare

    instructions for optimal results.

    Pregnancy/BreastFeeding/IVF: Those who are pregnant, breastfeeding, or going through IVF treatments

    are in no way permitted to undergo tattooing procedures. In good conscience, your artist will not tattoo

    someone responsible for the physical health of a growing fetus/infant.

    Under 18 years of age: It is unlawful in the state of New Jersey for those under the age of 18 years old to

    undergo tattooing treatments. Reprisal reserves the right to refuse service to those under the age of 18 even

    with presence or written consent of a legal guardian.

    Liability Consent: I acknowledge that the artist is A non-physician, licensed and insured medical

    micropigmentologist and hold harmless the artist from any and all claims damages or legal actions rising

    from or connected in any way to my cosmetic tattooing treatment

    Agreement of Financial Responsibilities I understand when booking my appointment I have agreed to the

    Terms and Conditions of Reprisal including the late, no show, and late cancellation policies and accept full

    responsibility for the penalties that may occur if I should breach the Terms and Conditions of my

    appointment(s).

    I understand there is a NO REFUND policy for cosmetic tattoo services and if for any reason,

    my pigment does not stay or needs more touch ups I agree to contact Avery Isernia for further

    discussions on additional applications. However, I am fully aware refunds will not be received.

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