Tattoo & Body Piercing Procedure Waiver

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

The date of my appointment is

Date

I understand that this is a binding contract with EVS.Tattoo & I have been given full opportunity to ask any and all questions about my procedure. All of my questions have been answered to my satisfaction. I understand that my procedure may be permanent, and may require surgical procedure for removal. I am aware that removal may cause scarring.

I do not have any medical conditions or communicable diseases (including but not limited to diabetes, epilepsy, hemophilia, hepatitis, HIV, AIDS, tuberculosis, COVID19). I do not have a skin condition that may interfere with the proper healing of my procedure (including but not limited to acne, scarring or keloids, eczema, psoriasis, freckles, moles, or sunburn).

I am not pregnant or nursing. I have informed the agent of EVS.Tattoo and documented below of any exceptions to the above. I am not under the influence of drugs, alcohol, or any narcotic, including but not limited to prescription pharmaceuticals, & over the counter medications. I am aware that being under the influence can have an adverse effect on the procedure. I agree that EVS.Tattoo cannot determine if I will have an allergic reaction to any of the products used to complete my procedure. I attest that I have no known allergies, or if I do I have documented them on the back of this form and alerted the agent of EVS.Tattoo.

I am aware of the possibility of infection with my procedure. I understand that when I leave the premises of EVS.Tattoo, my procedure is only half complete. It is my responsibility to follow the aftercare procedures recommended by EVS.Tattoo. EVS.Tattoo makes no claim to the success or validity of the recommended aftercare procedures, they are simply guidelines. I agree to not hold EVS.Tattoo liable for any necessary touch-up work cause by my own negligence. I understand that skin colour will have an effect on the final result of my tattoo. I agree to leave the premises of EVS.Tattoo or any other location where EVS.Tattoo is engaged in business promptly upon request, for any reason whatsoever, by any employee or agent of EVS.Tattoo.

Today's Date

Date

Signature

Tattoo Waiver