Clone of Tattoo Consultation & Consent Form

  • Pre-Tattoo Treatment Form

    Eternal Alchemy Ink, Tattoo & Fineline by Jade

  • This form is completed on the day of your appointment to confirm final treatment details, check your suitability to proceed, check over your pre consultant & concent form, and record your consent prior to tattooing.

  • Clients Details

  • Date*
     - -

  • Age & ID Check (Important)

  • Photographic ID check in person (options)?*

  • Final Health Check

  • Please answer the following to confirm that it is safe and appropriate to proceed with treatment today.

  • Have you consumed alcohol within the last 24 hours?*
  • Have you taken any recreational drugs within the last 24 hours?*
  • Have you taken Painkillers or blood thinning medication within the last 24 hours?*
  • Are you currently pregnant or breastfeeding?*
  • Do you experience dizziness or fainting episodes?*
  • Have you applied numbing cream prior to your appointment?*

  • Final Treatment Details

  • Consent To Proceed

  • Please read and confirm the following before treatment (tattoo) begins.

  • Please confirm the following*

  • Photography & Videography Consent

  • Treatment record photographs and videos help document your appointment accuratel. Marketing content is optional and will always be respected. All marketing content will NOT include faces, unless it is a tattoo in the area. 

  • Do you consent to photographs and videos being taken for treatment records?*
  • Do you consent to photographs and videos being used for portfolio, website and social media purposes?*
  • Do you consent to photographs and videos being edited by myself or my editor of choice?*

  • Aftercare Acknowledgement

  • By signing below, you confirm that the information provided is accurate to the best of your knowledge and that you concent to proceed with the treatment (tattoo).

  • Date*
     - -
  • Date*
     - -

  • Eternal Alchemy Ink — Fine Line Tattooing by Jade

    Mangotsfield, Bristol

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