Tattoo Consent Form
Please fill this out before your appointment let us know if you have any questions!
Client Information
Name
*
First Name
Last Name
Preferred Pronouns
Birth Date
*
-
Month
-
Day
Year
Date
Phone Number
Format: (000) 000-0000.
Email
*
example@example.com
Pre-Procedure Questionnaire
Are you pregnant or nursing?
*
Yes
No
Are you under the influence of drugs or alcohol?
*
Yes
No
Do you have a communicable disease?
*
Yes
No
Do you have any skin conditions?
*
Yes
No
Do you have any allergies? I.e latex, adhesive, foods etc.
*
Yes
No
Not sure
Acknowledgment and Waiver
*
I understand that this procedure is a permanent change to my skin and body.
*
I allow my tattoo to be photographed and be used for the artist’s portfolio & possibly showcased.
*
I acknowledge that the artist does not offer refunds for deposits or total final tattoo costs.
*
I agree that the artist does not have a way of identifying if I am allergic to the elements or ingredients that will be used for my tattoo.
*
I understand that I need to take care of the tattoo by following the instructions given to me by the artist.
*
I understand that I might get an infection if I don't follow the instructions given to me in regards of taking good care of my tattoo.
*
I indemnify and hold harmless the tattoo artist against any claims, expenses, damages, and liabilities.
*
I confirm that the information I provided in this document is accurate and true.
Type your name to agree to terms
*
Signed Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: