Tattoo Consent Form
Name
First Name
Last Name
Client Information
Age
Birth Date
-
Day
-
Month
Year
Date
Phone Number
Format: (000) 00000000000.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Pre-Procedure Questionnaire
Are you at least 18 years old?
Yes
No
Have you eaten within the last 3 hours?
Yes
No
Are you pregnant or nursing?
Yes
No
Do you have any skin conditions?
Yes
No
Skin conditions (e.g. Rashes, eczema, infection, psoriasis, freckles, etc.)
If yes, please identify the condition.
Medical Checklist
Please tick all that apply
Heart condition
Epilepsy
Haemophilia (clotting disorders)
Hepatitis B/C/O, HIV or other bloodborne infections
Diabetes or Lupus
Allergies / Past allergic reactions
Prescription medications
Please tell about your medical history (e.g. Diabetes, Cardiovascular Disease, Epilepsy, Blood-related disease etc.)
If yes, please identify the condition.
Acknowledgment and Waiver
Permanency
I understand that tattoos are a lasting form of body art. While removal options exist, they can be costly and may not fully restore the skin to how it was before. I'm happy to go ahead knowing this is a permanent decision.
Spelling
I understand that it’s up to me to check any spelling, dates, or meanings in my tattoo design — whether it’s something I brought in or picked from a flash sheet. I know the studio can’t be held responsible for errors in text or symbols.
Fading
I understand that tattoos can change slightly over time — colours might fade a bit, and how it heals can depend on my skin and body. That’s normal and part of how tattoos age naturally.
Aftercare
I’ve been given aftercare instructions and understand that if I don’t follow them, I could risk infection or healing issues. If any touch-ups are needed due to my own neglect, I accept that they’ll be at my own cost.
Type a question
I confirm that I am at least 18 years old, and consent to receive a permanent tattoo.
I have disclosed any medical conditions truthfully and understand that allergic reactions are possible.
I accept full responsibility if I choose to use numbing cream and understand it is used at my own risk.
I will follow the aftercare instructions provided, and understand that failure to do so may result in complications.
I allow my tattoo to be photographed and used for portfolio or social media purposes.
I understand that the studio does not offer refunds, and I release the Tattoo Shop from any liability related to the procedure.
I understand that the artist will do their best to replicate the agreed design, but due to the nature of tattooing and individual skin differences, the final result may not be an exact copy of the reference or stencil.
I confirm that all information I provided in this document is accurate and true.
Signed Date
-
Day
-
Month
Year
Date
Submit
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