Tattoo Consent Form

Tattoo Consent Form

Pink Fluff Tattoo
Client Information
Full Name

First NameLast Name
Location

Cloverdale, BCBelfast, NI
Age*
Date of Birth*

MonthDayYear
Date
Phone Number*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Instagram handle
How did you hear about Pink Fluff Tattoo?
Date of tattoo*

MonthDayYear
Date
Pre-Procedure Questionnaire
Are you under the influence of drugs or alcohol?

YesNo
Have you had a tattoo before?

YesNo
Please tick box;

Do you suffer from haemophiliaDo you get keloidsDo you faint easyPregnant of breastfeedingTaking AccutaneSuffer from skin sensitivitiesTaking blood thinning medications
Any Allergies ?
If yes, please identify the allergies
Skin conditions (e.g. Rashes, eczema, psoriasis or skin infections)
If yes, please identify the condition.
Medical History (e.g. Diabetes, Heart Disease, Epilepsy, High or Low Blood Pressure, auto immune disease, Hepatitis B or C, HIV or Transmittable Diseases) Please list any medications you are taking.
If yes, please identify the condition.
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 online portfolio.
I acknowledge that Pink Fluff Tattoo does not offer a refund.
I agree that the Pink Fluff Tattoo 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 aftercare given to me by the Pink Fluff Tattoo after my procedure.
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 indemnity and hold harmless Pink Fluff Tattoo against any claims, expenses, damages, and liabilities.
I am aware that my location choice of my tattoo may alter the healed results
I confirm that the information I provided in this document is accurate and true.
I have been fully informed of the inherent risks associated with the process of getting a tattoo and the importance of proper aftercare and healing of a tattoo. I fully understand that these risks, known and unknown, can lead to injury, including but not limited to scarring, infection, difficulties in detecting melanoma, allergic reactions to tattoo pigment, latex gloves, and/or soap. I also state that I have not excluded any important health conditions that I have had or may have. I have been informed of the potential risks associated with getting a tattoo, yet I wish to proceed with the tattoo application and I freely accept and expressly assume any and all risks that may arise from tattooing.

Therefore, I hereby release any and all persons representing Pink Fluff Tattoo from all responsibility. I accept any and all responsibility myself for the consequences that might stem from my decision to have any tattoo done by a Pink Fluff Tattoo artist. I agree to not sue Pink Fluff Tattoo for damages from my decision to have any tattoo work. I agree for myself, heirs and legal representatives to hold Pink Fluff Tattoo harmless of all damages, actions, causes of action, claim judgements, costs of litigation, attorney's fees and all other expenses which might arise from my decision to have any tattoo related work done by Pink Fluff Tattoo. I hereby acknowledge that by signing this agreement, I certify that all information provided is true.
Signed Date*

MonthDayYear
Client Signature*

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Upload photographic ID (proof of age)*

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Tattoo Consent Form

Client Information

Pre-Procedure Questionnaire

Acknowledgment and Waiver