Art On Skin Tattoo Consent Form

Name*

First NameLast Name

Date of Birth*

Date

Phone Number*

Area CodePhone Number

Email*

example@example.com

Please upload a photo of your proof of ID

Browse Files

Drivers Licence, Proof of Age or Passport - Please block out Licence/Passport Number/Card Number before submitting. Please see our privacy policy here https://artonskin.com.au/privacy

Emergency Contact *

Full NameContact number

In the past 14 days have you felt unwell or had any symptoms of Covid-19 (such as fever, coughing, shortness of breath), returned from overseas, had any contact with a confirmed or suspected case of Covid-19?*

YESNO

Have you eaten in the last 4 hours?*

YESNO

Have you consumed alcohol in the last 8 hours?*

YESNO

Are you under the influence of drugs?*

YESNO

Have you taken aspirin, ibuprofen or blood thinners in the last 24 hours?*

YESNO

Are you prone to heavy bleeding?*

YESNO

Do you have a latex allergy?*

YESNO

Are you pregnant or breastfeeding?*

YESNO

Are you prone to fainting?*

YESNO

Do you have any other allergies?*

write 'no' if no other allergies

Have you had the covid vaccination within the last 30 days?*

YesNo

Do you have any other conditions that might affect the healing of this tattoo?*

write 'no' if no other conditions

How did you hear about us?

I acknowledge by signing this consent form that I have read and agree to the following:

(1) I do not have diabetes, epilepsy, hepatitis, HIV, AIDS or any other communicable disease.

(2) I do not have any medical or skin conditions such as but not limited to: acne, scarring (Keloid), eczema, psoriasis, moles or sunburn in the area to be tattooed that may interfere with the tattoo. If I have any type of infection or rash anywhere on my body, I will advise my tattoo artist.

(3) I willingly submit to these procedures with a full understanding of possible complications such as but not limited to, infection, allergic reaction or rejection of the ink.

(4) Neither the artist nor the tattoo studio is responsible for the meaning or spelling of the tattoo I have agreed to. I have checked and approved the tattoo stencil.

(5) I understand I will be tattooed using appropriate instruments and techniques. To ensure proper healing of my tattoo, I agree to follow the aftercare suggestions provided verbally and provided online at http://www.artonskin.com.au/tattoo-aftercare.html until healing is complete. I understand that it usually takes 2 weeks or longer to heal. I agree that any touch-up work needed, due to my own negligence, will be done at my own expense.

(6) I understand that any employee or agent of Art On Skin when performing a tattoo does not act in the capacity of a medical professional. The suggestions made are just suggestions and they are not to be construed or substituted for advice from a medical professional.

(7) I understand that if I have any skin treatments, laser hair removal, plastic surgery or other skin altering procedures, it may result in adverse changes to my tattoo.

(8) I acknowledge that by having this tattoo performed that I am making a permanent change to my body and no claims have been made regarding the ability to undo the changes made.

(9) To my knowledge, I do not have a physical, mental or medical impairment or disability which might affect my well being as a direct or indirect result of my decision to have a tattoo.

(10) I acknowledge that the obtaining of my tattoo is by my choice alone and I consent to the application of the tattoo and to any actions or conduct of the representatives and employees of Art On Skin that are reasonably necessary to perform the tattoo procedure.

(11) I accept to release and forever discharge the employees and representatives of Art On Skin from any and all claims, damages and legal actions arising from or connected in any way with my tattoo of the procedures and conduct used to apply my tattoo.

(12) I acknowledge that I have truthfully represented to the employees and representatives of the tattoo shop that I am over the age of eighteen (18) years old, and that the information on this form is true and correct.

I release all rights to any photographs taken of me and the tattoo and give consent in advance to the reproduction in print or electronic form. I acknowledge that I had the opportunity to ask questions regarding this procedure and all questions were answered to my satisfaction.

Signature*

Date*

Time of your appointment*

:HourMinutesAM/PM Option

Name of your Tattoo Artist*

If you have any additional notes or comments in relation to your tattoo please notify your artist and write here:

TATTOO CONSENT FORM