• TATTOO CONSENT

    TATTOO CONSENT

    & RELEASE FORM
  • Client information

    Client information

    Section 1/5
  • Date of birth*
     / /
  • Format: (000) 000-0000.
  • Tattoo and appointment information

    Tattoo and appointment information

    Section 2/5

  • I,    *   *   ; give consent to    *   to apply the above stated tattoo to my body on   Pick a Date*   

  • Legal

    Legal

    Section 3/5
  • I acknowledge that I have truthfully represented that I am over the age of 18*
  • I acknowledge that obtaining this tattoo is MY choice alone .*
  • I acknowledge that I am not under the influence of drugs or alcohol*
  • I acknowledge that I am NOT pregnant or nursing (breastfeeding).*
  • I fully understand that there are always risks involved in getting a tattoo and that these risks (known and unknown), can lead to injury or death. These risks include but are not limited to; infection, scarring, difficulties in detecting melanoma and permanent disfigurement*
  • I acknowledge that allergic reaction to: pigments, gloves, soap, topical ointments used during and after the tattoo process, adhesives from bandages and the bandage itself; is always possible and that it will affect the healing and potentially the healed outcome of the tattoo.*
  • I acknowledge that I have been given the opportunity to ask any and all questions that I might have about obtaining a tattoo at MISFIT TATTOO and that all of my questions have been answered to my full and total satisfaction and understanding.*
  • I acknowledge that a tattoo is a permanent change to my body/appearance and may alter the way people may act and/or perceive me which may affect me personally and professionally.*
  • I acknowledge that I am free of any and all communicable diseases such as but not limited to Hepatitis, HIV and AIDS.*
  • I acknowledge that I DO NOT have any physical, mental or medical impairment or disability which might affect my well-being as a direct or indirect result of my own personal decision to have a tattoo done at this time.*
  • I acknowledge that I DO NOT have any diseases or disorders that may directly affect the tattoo process and or healing such as but not limited to; diabetes, hemophilia or a heart condition and that if I do have any diseases or disorders that may affect the tattoo that I have let my artist know prior to the appointment date and that I am taking all my prescribed medications and have gotten the okay from my doctor to go ahead with the procedure prior to booking this appointment.*
  • I acknowledge that I DO NOT have any skin conditions that may directly affect the tattoo process and or healing such as but not limited to; rash, boils, eczema, shingles, psoriasis, abrasions or sunburn anywhere near the location of the tattoo placement and that if I do I have let my artist know, am following my dermatologist/doctors orders regarding treatment and have gotten the go ahead with the procedure prior to this appointment .*
  • I acknowledge that I am NOT the recipient of an organ or bone marrow transplant or if I am that I have taken the prescribed preventative regimen of antibiotics that is required by my doctor in advance of any invasive procedures such as getting a tattoo and have spoken to my doctor directly prior to getting tattooed .*
  • I acknowledge that neither THE ARTIST or MISFIT TATTOO is responsible for the meaning or spelling of any symbols, text or numerals that I have provided to them.*
  • I acknowledge that everybody’s skin is different and that variations in colour, texture and design may exist between the tattoo art I have selected and the actual tattoo itself when it is applied to my body.*
  • I acknowledge that over time tattoos age and may change in appearance over time and that I understand proper tattoo care goes well beyond the healing process and that pigment loss or fading is always possible due to ageing and unprotected exposure to the sun.*
  • I acknowledge that I will be tattooed using the appropriate instruments required for the procedure. I acknowledge that all needles and barriers are single use disposable only and that proper sterilization of all re-useable equipment set forth by Ottawa Public Health has been followed.*
  • I acknowledge that by signing this release that I have been given all of the appropriate information surrounding the tattoo process prior to obtaining the tattoo.*
  • Signature

    Signature

    Section 4/5
  • Today's Date:
     - -
  • Media Consent

    Media Consent

    Section 5/5
  • I give MY ARTIST and MISFIT TATTOO permission to take photos and videos during my session and that I release all rights of any photographs taken of me and my tattoo(s) in advance. I give permission to MY ARTIST and MISFIT TATTOO to use my photos for their portfolio, marketing, website and social media use for however long and as many times as they (the artist) sees fit.*
  • Should be Empty: