Client Consent Form

* Indicates required field

Name *

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Last

Copy of ID *

Max file size: 20MB

Email *

Phone Number *

Ink *

Color Black & White

Tattoo Location *

Tattoo Description (ex. Skull, Butterfly, etc.) *

I am 18 years of age or older or am accompanied by an adult if a minor *

I am not pregnant or nursing. *

I am not under the influence of drugs or alcohol *

If I have diabetes, epilepsy, hepatitis, hemophilia, HIV-AIDS or any other communicable disease, heart condition or take medicine which thins the blood I have advised my tattoo artist. *

I do not have medical or skin conditions such as but not limited to acne, scarring (Keloid) eczema, psoriasis, freckles, moles, or sunburn in the are to be tattooed that my interfere with the tattoo. *

I acknowledge it is not reasonably possible for the representatives and employees of this tattoo shop to determine whether I might have an allergic reaction to the pigments or processes used in my tattoo, and I agree to accept that such risk is possible. *

I realize the variations in color and design may exist between any tattoo as selected by me and as ultimately applied to my body. I understand that if my skin color is dark, the colors will not appear as bright as they do on light skin. *

I acknowledge that infection is always possible as a result of the obtaining of a tattoo, particularly in the event that I do not follow aftercare instructions. *

I agree that any touch-up work needed, due to my own negligence or not will be done at my own expense. *

I fully understand the TATTOO ARTIST IS NOT A MEDICAL PROFESSIONAL. *

I make this agreement freely and voluntarily and of my own free will. *

BY ENTERING YOUR FULL NAME BELOW YOU ACKNOWLEDGE THIS IS A FULL LEGAL SIGNATURE *

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