Tattoo 34 Waiver

4035 SE Hawthorne Blvd Portland, OR 97214
Is your tattoo (ink into skin) happening today?*

YesNo- wait to fill this waiver out until the day of your tattoo, it's Oregon state law.
Do you know which tattoo artist is going to be putting ink in to your skin?*

YesNo- wait to fill out this waiver until you know which artist you will be working with.
Is this your first time in, for the tattoo you are getting today?*

YesNo- I am continuing tattoo work or getting a touch up, on a tattoo that was originally done here at Tattoo 34 by the same artist who I am working with today.
Has any of your health or logistical information changed since your last time getting tattooed here at Tattoo 34 or has it been more than 12 months since you have been tattooed at Tattoo 34?*

YesNo- I agree this statement is true and accurate.
Waiver Release and Consent Form

I am at least 18 years of age and have presented identification to the tattoo artist for verification.

I am not under the influence of any type of drugs or alcohol.

I am not pregnant or nursing.

I understand a tattoo is a permanent change to my appearance and obtaining a tattoo is by my choice alone.

I understand there is the possibility of an allergic reaction (or resulting infection) to the pigments (ink), soap, witch hazel, lavender, lidocaine, adhesive, or other items/processes used in my tattoo.

The tattoo artist or Tattoo 34 is not responsible for the meaning or spelling of a symbol or text provided for a tattoo.

I understand that aftercare, lifestyle, and maintenance will effect my long term results. I also understand that if I have any skin treatments, laser hair removal, plastic surgery, injections, or other skin altering procedures, may result in adverse changes to my tattoo.

I understand there are security cameras in public areas of the shop. Footage is only reviewed to address any concerns (we haven't had any).

I agree to these statements entirely of free will and sound mind.
By signing here, I certify that I understand, accept the risks and fully agree to all of the terms above *

Clear
About You:
Image of ID- We are required by the State to keep a copy of your State or Federally issued photo I.D. Take a picture of your license or passport and upload: (please have your ID available at the time of your appointment, for your artist to verify information)*

Cancelof
Your Date of Birth (MM/DD/YYYY):*

MonthDayYear
Must be 18 to get tattooed
Your name, to call you- if different from ID:
Legal Name (that matches ID):*
Pronouns:
Your Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Email Address*
This email will get after care info. Your email will be added to our customer list.
Emergency Contact (first and last name)*
Just in case.
Emergency Contact Phone number*
Please enter a valid phone number.
About your Health:
Please check any condition that applies to you and then also tell your tattoo artist of any condition you marked. The conditions listed below can affect your tattoo or your artists ability to tattoo you. We don't discriminate, with more information your artist can better prepare.

DiabetesEpilepsyT.B. - TuberculosisHepatitisHIV/AIDSHemophiliaScarring/KeloidingHeart ConditionHerpes SimplexAuto-immune disorderCancer treatmentsIron deficiency/AnemiaFrequently Faint or DizzyHyperpigmentationPresent Skin Infections (staph etc.), Conditions (acne, rosacea, psoriasis, eczema etc.) or Sunburn (near tattoo area)Taking Blood Thinners (advil, aspirin etc.)Taking any medications that cause delayed healingThe use of Accutane, Retin-A, Alpha Hydroxy Acid
Do you have any other skin or health concerns or medication that you are taking, not mentioned, that you want to be sure we know about:
By signing below I am agreeing that I have fully read and consent to receive tattoo services and all the above questions are true and accurate. I have disclosed any and all health information that is relevant and I am assuming any and all risks that may arise from being tattooed today at Tattoo 34.
Client's Signature*

Clear
About Today:
Do you prefer a silent tattoo appointment (minimal talking/conversations with your artist during the tattoo process)?

Yes please, silent appointment is preferred.No thanks, chatting is great!Other- let your tattoo artist know.
Do you consent to photography and video of you, your tattoo and the process?

Yes
Do you have any worries or concerns (or general questions) you would like to talk with your tattoo artist about before your appointment?
Do you have any accessibility or general needs we should be aware of to make your tattoo appointment more comfortable?
About your Tattoo:
Who is your artist today?*
If you are not sure, don't continue with waiver until you know who is going to be putting ink into your skin!
Guest Artist Name:
What date is your tattoo being done? (This waiver needs to be filled out the day of)*

MonthDayYear
Default date is today
Select ALL that applies for TODAY'S tattoo work ONLY:*

First Tattoo EverContinuing Work on a Multiple Session TattooTouch UpWalk in TattooHand/Finger TattooCosmetic Tattoo (brows or lips)Medical Tattoo (scar camouflage)Color TestCover UpEvent, Pop-Up, Fundraiser, Trade or Special PromotionCupcake Tattoo FundNone of the above applies to me today
You indicated you will be getting a cosmetic or medical tattoo. For these types of tattoos you understand depending on your skin, at least one follow up appointment is recommended for optimal results. Further maintenance is recommended around 1.5-2 years.*

Agree
You indicated you will be getting a hand/finger tattoo.

Compared to other parts of the body hands are washed and exposed to the elements more frequently, along with having lots of constantly moving parts. Hands also shed skin cells faster than other areas of the body. All of that causes the hands to be a very tough place to heal. Even in the best of circumstances hand tattoos may fall out (not stay) or not stay well and the ink tends to expand (bleed) under the thin skin of fingers and hands. We often see client expectations, not matching the results. Hand tattoos are an at your own risk type of situation, we will do them but we do not offer free touch up's on hand tattoos.

By signing below you are agreeing that you understand the unique challenges of hand tattoos and are aware of the possibility that yours can expand, fade, or disappear completely. You also understand we do not offer free touch up's on hand tattoos. They can be touched up and/or redone but at your own expense.
Client's Signature*

Clear
Short description of your tattoo and where on your body*
location on body and content of tattoo
Total you are quoted for today's tattoo work (this session) or the hourly rate you are aware you will be paying? (Ask your tattoo artist now if you don't know). Walk in pricing is located in the lobby of the shop or on our website*
If you paid a deposit for today's tattoo session, how much?
Extra Info:
Are you?

New to us at Tattoo 34 (WELCOME!)Been here, back for more!
How did you hear about us?
If you have a promo code from the Rip City Remix, type it below:
Should be Empty:

Waiver Release and Consent Form

About You:

About your Health:

About Today:

About your Tattoo:

Extra Info: