Clone of Consent Form

Name

First nameLast name

Date of birth

Artist

If you have selected a guest artist please leave their name below.

Do you want access to cancellation spots, discounts and new flash designs?

Which ID are you bringing to your appointment?

Please tick to show you have read & understand all of my pre-tattoo information and are suitably prepared for your tattoo.

Medical History

Rows	Please select if the following apply to you
High blood pressure
Epilepsy
Heart disease
Diabetes
Psoriasis
Low blood pressure
Heart murmurs
Impetigo
Warts
History of haemorrhaging
Pace maker
Hepatitis
Immunocompromised
Acne
Eczema

Are you currently taking any medication?

If yes, please detail below.

Allergies

Rows	Please select if the following apply to you
Metal
Alcohol wipes
Adhesive tape or plasters
Latex
Nut

Do you suffer from any other health issues, including mental health? This is so I can understand your needs and to make sure you feel supported and safe, this information is not mandatory but the right support can mean a better quality of work and a better experience for both parties.

If yes, please detail below if you are comfortable sharing and how I can best support you to make your experience better.

Are you neurodivergent? This is so I can understand your needs and to make sure you feel supported and safe, this information is not mandatory but the right support can mean a better quality of work and a better experience for both parties.

If yes, please detail below if you are comfortable sharing and/or add any support I can provide to make your experience better. (bringing a friend, headphones, screens, etc.)

Are you pregnant or breastfeeding?

Are you under the influence of drugs or alcohol?

Are you leaving the country in the next 2 weeks?

Are you regularly swimming or spending time outside?

If your tattoo is WRITING/NAMES/DATES please put the correct spelling below as I will use this for reference to avoid mistakes.

Disclaimer
No tattoo can be 100% perfect, but we will always try our best to meet your expectations. All skin is different, and this can be reflected in the healing process, especially on the hands, fingers, wrists, feet and ankles. One touch up in these areas will be free, subsequent touch ups will be priced accordingly.

We reccomend not using numbing cream as it can affect the healing and can cause a reaction. If you do choose to use numbing cream it is at your own risk and any touch ups will be a minimum of £50.

By signing below you are giving us permission to share your tattoo and possibly your presence in the studio on my social media.

I hereby declare that I am of legal age to get tattooed and I am competent to sign this agreement or, if not, my parent or legal guardian should sign on my behalf, and that my parent or guardian is in complete understanding and concurrence with this agreement.

Full name

First NameLast Name

Date of birth

Pronouns

Preferred name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone number

Email

example@example.com

Emergency contact

First NameLast Name

Emergency contact number

Relationship to you

Todays date

Data Protection: The information you provide me with will not be shared with third parties, it will be stored in a secure place and will be destroyed in compliance with data protection laws.