Consent Form Name * First Name Last Name Date of Birth * Phone (###) ### #### What services are you interested in? * Tattoo By checking the boxes and signing below, I agree and acknowledge the following: I am not under the influence of drugs or alcohol. I am not pregnant or nursing. I do not have any condition(s) (e.g., hemophilia, epilepsy, diabetes, skin conditions, allergies, infections) that may affect the healing or safety of this tattoo. I have informed the artist of any allergies or health conditions that may impact the procedure. I am willingly receiving a tattoo and have requested this procedure of my own free will. I understand a tattoo is permanent and may only be removed by surgical means or laser, which can be costly and ineffective. I have reviewed and approved the final design, spelling, and placement of the tattoo. I understand changes after the tattoo is applied are not possible. I have been given verbal and or/ written aftercare instructions and understand I am solely responsible for following them. I understand there are risks associated with tattooing including, but not limited to, scarring, infection, allergic reaction, and complications. The tattoo artist makes no guarantees or warranties regarding the final appearance of the tattoo. I hereby release and hold harmless the tattoo artist and studio from all claims, damages, or legal actions that may arise from the tattoo procedure, regarding of cause, including negligence. I confirm I am at least 18 years of age. No minors will be tattooed regardless of parental consent unless permitted by law. I consent to photographs of my tattoo being taken and used for marketing/portfolio purposes. Signature * Thank you!
