Liability Waiver

LIABILITY WAIVER

Client and Artist Agreement
Client Information

This form must be carefully completed by the client requesting our body art (tattoo) services. I certify that I have been informed by the artist and/or assistant about the prohibition of tattooing individuals under 21 years of age, or persons who are mentally incapacitated or with extreme health conditions without certified medical approval for tattooing. (Law 318.18/October/99, Article 9 of Prohibition).
Name Last Name*
Age*
Date of Birth*

MonthDayYear
Phone*
Drivers Licence Number*
Email*
Address *

Street Adress

TownCountry

Postal Code
Medical History

Please indicate if you have or have had any of the following health conditions:
HIV*

YesNo
ASMA*

YesNo
High Blood Pressure*

YesNo
Hemophiliac*

YesNo
Epilepsia*

YesNo
Anemia*

YesNo
Heart Disease*

YesNo
Psychological Conditions*

YesNo
Dermatological Disease*

YesNo
Are You Alive?*

YesNo
Hepatitis*

YesNo
Allergies to Soaps and/or Cosmetics*

YesNo
Depression*

YesNo
Allergic to Alcohol*

YesNo
Diabetes*

YesNo
Latex Allergies*

YesNo
Are you pregnant? Pregnancy is a stage where the person should be in the calmest possible state and avoid any stressful situations, as the fetus or baby feels what you feel. Therefore, we recommend not getting any tattoos during this period to avoid any complications. At The Mindset Studio, we care about your health and your baby's.*

YesNoN/A
Liability Disclaimers
Mindset Creatives LLC or The Mindset Studio and its employees are not responsible for damages to vehicles or stolen items inside the car in the building's parking lot. It is important to properly lock your car and leave it in a safe area.*

Acknowledged.
Mindset Creatives LLC or The Mindset Studio and its employees are not responsible for falls on the stairs, health or property damages within the building. It is necessary to use resources with discretion and take universal safety measures.*

Acknowledged.
Mindset Creatives LLC is not responsible for the use of anesthetics and healing creams or their reactions to the products, as each body is different, and the client should read before applying them to their skin.*

Acknowledged.
Client Consent
I, First Name Last Name of legal age, am aware and have been informed that getting a tattoo is permanent, lifelong, and involves needles that pierce the skin and requires post-procedure care. I certify that I have been provided with a Care Sheet outlining the steps to follow to care for my tattoo and have been advised that if I experience any allergic reaction or signs of infection, I should immediately consult my primary doctor or visit an emergency room as soon as possible. If not, I should immediately request the information and Care Sheet from the assistant on duty.
I certify that I have been informed about the design and approved it before proceeding. The design (names/letters/phrases) is correctly written and is the design I chose at the time of request.*

I Agree
I certify that all the information provided by me is correct and that I have carefully read this form and understand and accept, of my own free will, everything described herein and in the Waiver of Liability.*

I Agree
Is this your first tattoo?*

YesNo
Acknowledgment
By signing this agreement, I acknowledge that I have been given the full opportunity to ask any questions I may have about obtaining a tattoo and its procedures, and that all my questions have been answered to my complete satisfaction. The tattoo studio will retain this document for two (2) years. With my signature on this document, I declare that I am of legal age (21 years or older) and, through this waiver of liability, I am authorizing myself to undergo a tattoo procedure with the artist of my own choosing, who will also sign this Waiver. I also declare that I have no mental impairment and have not been declared incapacitated by any court of law or administrative procedure.

I specifically acknowledge that I have been informed of the facts and matters set forth below and agree to the following:
I authorize photos/videos to be taken of me and my tattoo/body area and give consent for them to be used as promotion by The Mindset Studio/The Mindset Metro on all existing social media and media platforms.*

I Agree
To my knowledge, I have no physical, mental, or medical impairment or disability that could affect my well-being as a direct or indirect result of my decision to get a tattoo.*

I Agree
If I have diabetes, epilepsy, hepatitis, hemophilia, HIV/AIDS, or any other communicable disease, heart condition, or if I am taking any blood-thinning medication (such as any treatment for hemophilia), I have fully disclosed/notified my tattoo artist.*

I Agree
I certify that I was informed about the design and approved it before it was performed. The design (names/letters/phrases) is correctly written and is the design I chose at the time I requested it.*

I Agree
I am not under the influence of alcohol or any drug that could impair my ability to give consent or that could potentially affect the tattoo procedure.*

I Agree
I have no medical or skin conditions such as acne, scar tissue (keloids), psoriasis, allergies to pigments, freckles, moles, or sunburns, among others, in the area to be tattooed that could interfere with the tattoo. The tattoo artist has the right to refuse to perform any tattoo on any area of the body that shows signs of drug abuse, injuries, or dermatological conditions.*

I Agree
I acknowledge that it is not reasonably possible for the representatives and employees of this tattoo shop to determine whether I might have an allergic reaction to the pigments or processes used in my tattoo, and I agree to accept the risk that such a reaction is possible.*

I Agree
I acknowledge that the tattoo may be performed by an apprentice under the direct supervision of a licensed tattoo artist. (Apprentices are considered artists without a Dermatographic Artist License.)*

I Agree
I acknowledge that I have been informed that my tattoo should not be exposed to the sun for three (3) weeks and that I must use sterile gauze to frequently clean the tattooed area.*

I Agree
I acknowledge that infection is always a possible risk as a result of getting a tattoo, especially if I do not properly care for my tattoo. By signing this release, I declare that I have received the Aftercare Sheet and agree to follow its instructions during the healing process. I accept that any necessary touch-up work, due to my own negligence, will be done at my own expense and I will be charged for it. I also understand that in the event of an infection, or any symptoms related to an infection or allergic reaction in the tattooed area, I must consult a physician.*

I Agree
I understand that there may be variations in color and design between the tattoo I selected and the one ultimately applied to my body. I understand that if my skin tone is dark, the colors may not appear as bright as they would on lighter skin. I also understand that weight loss or weight gain may, in some cases, affect the appearance of my tattoo.*

I Agree
I understand that if I undergo any skin treatments, laser hair removal, plastic surgery, or other skin-altering procedures, adverse changes to my tattoo may occur.*

I Agree
I acknowledge that a tattoo is a permanent change to my appearance and that no representations have been made to me regarding the possibility of changing or removing my tattoo in the future. I also acknowledge that I have not been coerced into undergoing the tattoo procedure.*

I Agree
I give my consent for the application of the tattoo and for any actions or conduct by the representatives and employees of the tattoo shop that are reasonably necessary to perform the tattoo procedure.*

I Agree
If I am breastfeeding my baby, I must provide proof of medical authorization before undergoing any tattoo procedure. The tattoo artist has the right to refuse to perform any tattoo if the above criteria are not met.*

I AgreeN/A
I also acknowledge that I was properly informed, both verbally and in writing, about how to manage and care for my tattoo, and that getting a tattoo is a permanent and irreversible procedure.*

I Agree
I fully understand that THE TATTOO ARTIST IS NOT ACTING AS OR CLAIMING TO BE A MEDICAL PROFESSIONAL. Any suggestions or instructions given to me should NOT be interpreted as or substituted for the advice of a medical professional.*

I Agree
Therefore, I request the tattoo artist to tattoo my: (Body Area) (Check all that apply).*

Right ArmLeft ArmRight HandLeft HandRight LegLeft LegChestBackNeckFaceHeadStomachButtocksGenital AreaOther (Specify)
The Design to be Tattooed will be: Brief description of the work to be performed*
I understand that this type of tattoo typically takes 3 WEEKS OR MORE TO HEAL. I hereby release and forever discharge Mindset Creatives LLC, the tattoo artist, and all affiliates, owners, managers, and employees from any and all claims, damages, or legal actions arising from or in any way related to my tattoo, or the procedure and conduct used in my tattoo, to the fullest extent permitted by LAW.*

I Agree
I Name* Last Name* accept that I have read the Tattoo Authorization Form provided by an Artist (Professional Services) of Mindset Creatives LLC and I agree to its terms.
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In accordance with the Puerto Rico Electronic Transactions Act (Act No. 148-2001), both the customer and the artist acknowledge and agree that typing their full name in block letters in the spaces provided below constitutes a valid and binding electronic signature, with the same legal effect as a handwritten signature.
Client Full Name

First NameLast Name
Artist Full Name

First NameLast Name
Signed Date*

MonthDayYear
Date
INTERNAL RECORD (Artist or Manager)
Pigments Used*
Needles Used*
Artist and Artist License Number*
Pigmentos Utilizados *

Fecha Fecha de Expiracíon
Agujas Utilizadas*

MarcasFecha de Expiracíon
Nombre de Artista y Número de Licencia *

Nombre y Apellidos de ArtistaNumero de Licencia de Artista (AD)
Should be Empty:

Client Information

Medical History

Liability Disclaimers

Client Consent

Acknowledgment

INTERNAL RECORD (Artist or Manager)