Name *

First Name

Last Name

Appointment date *

MM

DD

YYYY

Date of birth *

MM

DD

YYYY

I have read, understand and agree to be bound by the following: *

please tick the boxes to confirm your agreement.

If I have diabetes, epilepsy, hepatitis, haemophilia, HIV-AIDS, any other communicable disease, heart condition or take medication which thins the blood, I have advised my artist. I am not pregnant or nursing. I am not under the influence of alcohol or drugs.

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

I acknowledge that it is not reasonably possible for the artist to determine whether I may have an allergic reaction to the pigments or processes used in my tattoo, and I agree to accept the risk that such a reaction is possible.

I acknowledge that infection is possible as a result of getting a tattoo, particularly in the event that I do not take proper care of my tattoo. I agree to follow aftercare instructions, and agree that any touch-up work needed due to my own negligence or failure to follow aftercare instructions, will be done at my own expense.

I acknowledge that variations in colour and design may exist between any tattoo as selected by me and as ultimately applied to my body.

I understand that any future skin treatments, laser hair removal, plastic surgery or other skin altering procedures may result in adverse changes to my tattoo.

I acknowledge that a tattoo is a permanent change to my appearance and that no representations have been made to me as to the ability to later change or remove my tattoo. 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.

I am over the age of 18, and confirm that the obtaining of a tattoo is by my choice alone. I consent to the application of the tattoo and any actions or conduct by the artist reasonably necessary to perform the tattoo procedure.

I give consent that both my artist and the studio reserve all rights to use any photos or footage taken of my tattoo.

I acknowledge that neither the artist or studio are responsible for the meaning or spelling of the symbol or text I have provided to them or chosen.