Ritual Tattoo Agreements + Consent
Please read the information below to ensure you fully understand the agreements for ritual tattoos.
Client Name
First Name
Last Name
E-mail
example@example.com
Phone Number
-
Area Code
Phone Number
Sacred Agreement
This is a ceremonial space rooted in respect, integrity, and care. By signing this form, you enter into a sacred agreement of mutual respect and responsibility. Ritual tattoos are a collaborative, intentional process. The ceremony belongs to you — I hold space as your artist and guide, but the meaning, integration, and responsibility remain with you.
Acknowledgement of Ritual Tattoo Process
Ritual tattoo sessions at Root + Ritual combine tattooing with elements of meditation, energy work, and ceremonial practices. These experiences are designed to support personal reflection, intention-setting, and spiritual expression.
Important Agreements
By checking the boxes below, I acknowledge that I have read and understood each statement.
I understand that my tattoo artist, Victoria Moon / Root + Ritual, is not a licensed therapist, counselor, medical provider, or mental health professional.
I understand that ritual tattoos are a form of body art and are not guaranteed to help treat, diagnose, or cure any physical, mental, or emotional illness.
I understand that ritual tattoos may include elements of physical touch (such as grounding, energy clearing, or supportive contact). The practitioner will always ask for my consent before any touch occurs.
I understand that I am fully responsible for communicating my boundaries and may accept or decline touch at any time.
I understand that if I need medical, psychological, or therapeutic support, it is my responsibility to seek licensed professional care.
I acknowledge that any spiritual, energetic, or emotional experiences that may arise during or after the ritual are my personal responsibility to integrate.
Signature
Tattoo Risks + Aftercare
I understand that receiving a tattoo involves puncturing the skin, which carries risks including infection, allergic reaction, and scarring.
I will follow the aftercare instructions provided by my artist to minimize risk.
I understand that tattoo ink may fade or blur over time.
I release my artist from liability related to normal risks of tattooing.
Signature
Personal Health Disclosure (please check all that apply)
I am pregnant or nursing
I have diabetes
I have a heart conditioner pacemaker
I have epilepsy or seizures
None of the above
If any of the above, I have informed my tattoo artist before the beginning of the session
Signature
Consent + Release
by sighing below, I:
Confirm that I am at least 18 years old
Consent to receiving a tattoo from Root + Ritual
Release my artist at Root + Ritual from any claims, damages, or legal actions arising from the tattoo procedure.
Acknowledge that I have read, understood, and agreed to all the above statements.
Signature
Continue
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