Screamin Eagle Tattoo Waiver & Release
Consent and health form for your tattoo procedure
Client Information
Full Legal Name
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First Name
Last Name
Date of Birth
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Month
-
Day
Year
Date
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Street Address
*
City
*
Province
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Please Select
British Columbia
Alberta
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Ontario
Prince Edward Island
Quebec
Saskatchewan
Northwest Territories
Nunavut
Yukon
Postal Code
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I confirm that I am at least 19 years of age, or I meet all legal requirements in British Columbia for tattoo procedures if under 19 with proper consent.
*
I confirm and agree
Tattoo Information
Tattoo Placement on Body
*
Description of Tattoo
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Acknowledgement of Studio Policies
I acknowledge that: • I have had the opportunity to review all studio policies and procedures. • It is my responsibility to ask questions before the tattoo procedure. • The artist reserves the right to refuse service at their discretion. • I will receive aftercare instructions and understand I must follow them.
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I have read and agree to the above statements
Health and Medical Disclosure
I confirm that: • I am not under the influence of alcohol or drugs. • I do not have medical conditions that could affect tattooing or healing unless disclosed below. • I am not pregnant or nursing. • I do not have allergies to latex, iodine, adhesives, or tattoo pigments unless disclosed below. • I have not taken blood-thinning medication within the past 24 hours unless disclosed below.
*
I have read and confirm the above statements
Please disclose any medical conditions, medications, allergies, or other relevant health information (optional)
Informed Consent to Tattoo Procedure
I acknowledge that: • Tattooing involves the insertion of pigment into the skin and carries inherent risks. • Tattoos are permanent and may fade or change over time. • No guarantees are made regarding tattoo removal or final healed appearance. • Healing results vary by individual. • I have been given the opportunity to ask questions about the procedure.
*
I have read and consent to the tattoo procedure
Release and Waiver of Liability
I hereby release and discharge Screamin Eagle Tattoo, its artists, employees, and representatives from any claims, damages, or legal actions related to the tattoo procedure, except in cases of proven negligence.
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I have read and agree to the release and waiver of liability
Photography and Marketing Consent
Do you allow photographs of your tattoo to be used for portfolio, marketing, or promotional purposes?
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Yes
No
Client Signature
By signing below, I confirm that I have read, understood, and agree to this waiver and release form, and that all information provided is accurate and truthful.
*
I confirm and agree
Digital Signature (please sign below)
*
Date
*
-
Month
-
Day
Year
Date
Submit
Submit
Should be Empty: