Tattoo Consent Form
Preferred Name
*
First Name
Last Name
Date
*
-
Day
-
Month
Year
Date of Birth
*
-
Day
-
Month
Year
Pronouns
*
Medical History
*
My blood pressure is regular
I have no heart conditions
I have never suffered from hepatitis A, B or C
I do not have any allergies or conditions that will affect this procedure
I am not diabetic
I do not have any blood clotting disorders
I am not pregnant or breastfeeding
I do not suffer from any form of seizure causing condition
I am not prone to dizziness or fainting
By ticking the boxes below, I agree:
*
I am over the age of 18, and have truthfully represented myself of age
I have eaten in the last 2 hours
I have not consumed drugs or alcohol in the last 24 hours
I understand that infection is always possible as a result of obtaining of a tattoo, particularly in the event that I do not take proper care of my tattoo
I will follow aftercare instructions given to me by my tattoo artist, and understand aftercare is solely my responsibility
I understand that variations in design may exist between any tattoo as selected by me and ultimately applied to my body
I understand that tattooing certain areas of the body may be more likely to result in natural reactions such as, but not limited: bleeding ink, keloid scarring or warping which may affect the final appearance of the tattoo
I understand that this tattoo is a permanent change to my body and I consent to that change
I consent to pictures of my tattoo being posted on social media
I understand that reactions to the pigment is possible, even after the tattoo has healed
I consent to any actions necessary to perform the tattoo procedure
Signature
Continue
Continue
Should be Empty: