• Olivia Tattoo Consent Form

    @cowgurl_bebop
  • Date*
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  • Your Date of Birth*
     - -
  •  -
  • I acknowledge that I am receiving my tattoo in the following location:*

  • Acknowledgment

    I acknowledge by signing this consent form that I have been given the full opportunity to ask any questions which I might have about obtaining a tattoo and that all of my questions have been answered to my full satisfaction. The tattoo artist will use new needles for the tattoo and provide care instructions once the tattoo is complete. I hereby release my tattoo artist and this studio from all liability, claims, actions, and demands in law, or in equity, which I may have by obtaining this tattoo. I also acknowledge I have truthfully and accurately answered the questions listed below

  • Are you over 18 years old?*
  • Have you been jaundice (yellowing of skin or eyes) in the past 10 days?*
  • Are you prone to fainting?*
  • Do you have diabetes?*
  • Do you have difficulty stopping bleeding?*
  • Do you take any blood thinners?*
  • Do you have any heart related problems?*
  • Do you have epilepsy?*
  • Do you have high blood pressure?*
  • Do you have any known allergies?*
  • Have you consumed any anticoagulants (aspirin, ibuprofen, etc) in the past 8 hours?*
  • Have you consumed any food in the last 3 hours?*
  • Do you have any conditions that may affect the healing of this tattoo?*
  • Are you pregnant or nursing?*
  • Are you under the influence of alcohol or drugs?*
  • Do you have any medical or skin conditions, like acne, scarring, psoriasis, or sunburn that may interfere with your tattoo?*
  • Do you acknowledge that it's reasonably not possible for your tattooer to determine wether you might have an allergic reaction to tattoo ink, and accept that risk of an allergic reaction is possible?*
  • Do you acknowledge that blow outs and infections are always possible as a result of being tattooed, during the tattoo or if you don't take proper care of it during the healing stages?*
  • Do you acknowledge that the first touch up is free and that any following touch ups, if needed, will be done at your own expense?*
  • Do you acknowledge that variations in color and design between the tattoo as selected and as ultimately applied to your body may occur?*
  • Do you acknowledge that your tattoo artist is not responsible for the meaning or spelling of the symbol or text you provided to them*
  • Do you acknowledge that any skin treatments, laser hair removal, plastic surgery or other skin altering procedures may adversely affect your tattoo?*
  • Do you acknowledge that a tattoo is a permanent change to your appearance, and that no promises have been made to you about the ability to later change or remove the tattoo?*
  • Do you agree to pay your artist's hourly rate or quoted amount in cash upon completion of the tattoo?*
  • Do you release all rights to any photographs taken of you by your tattoo artist and give consent in advance to their reproduction in print or electronic form?*

  • If no, please remind your tattoo artist not to take pictures of you and your completed tattoo. 

  • Informed Consent - COVID-19 Pandemic

  • I understand that I am opting for a service that is not urgent and not medically necessary.

    I also understand that the coronavirus disease (COVID-19) has been declared a worldwide pandemic by the World Health Organization. I further understand COVID-19 is extremely contagious. State and federal health agencies recommend social distancing.

    I recognize that the staff at Yarrow Studio are closely monitoring this situation and have put in place reasonable preventive measures targeted to reduce the spread of this virus. However, given the nature of the virus, I understand there is an inherent risk of becoming infected with COVID-19 if I proceed with this elective service.

    Accordingly I acknowledge and assume the risk of becoming infected with COVID-19 through this elective service and I give my express permission for the staff at Yarrow Studio to proceed with the same. This consent applies to any follow up or additional services in the upcoming months.

    I understand that even if I have been tested for COVID-19 and received a negative test result, the tests may not have detected the virus or I may have contracted COVID-19 after the test. I will not hold this business and professional offering the service responsible for any liability related to COVID-19 and any variation or mutation thereof.

    I understand that exposure to COVID-19 before, during, or after my procedure(s) may result in complications and/or delayed healing.

    I have been given the option to defer my service to a later date. However, I understand all the risks including those noted herein and I would like to proceed with this service. 

    I understand the explanation and consent to the procedure.

  • By signing this form, I reaffirm the answers provided above. 

  • Date*
     - -
  • Should be Empty: