Tina B

your Name *

First Name

Last Name

Phone number *

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your birthday *

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DD

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Date getting tattooed *

MM

DD

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Emergency Contact name *

First Name

Last Name

emergency contact Phone number *

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*

I certify that i am the person on the legal ID and of at least 18 years of age

I agree that i have reviewed the design, have checked the spelling, confirmed placement and size, and have given my full consent to the application of my tattoo. This consent can be retracted at any point during this appointment.

my desired placement is in ready condition for a tattoo, free of sunburn, rash, cuts/abrasions, and any other condition that may be unsuitable for a tattoo.

i understand and acknowledge it is not reasonably possible for my tattoo artists, their associates and representatives to determine whether i might have an allergic reaction to the dyes, pigments or processes used in my tattoo, and i agree to accept that such risk is possible.

i am not under the influence of drugs or alcohol.

i am free of communicable diseases.

i understand that there is a chance i might feel dizzy or lightheaded during or after my tattoo application. i will warn my tattoo artist immediately if these feelings occur. i will not drive while feeling lightheaded or dizzy.

i will follow the aftercare instructions provided by my tattoo artist and understand the importance of them. I understand that touch ups needed because of aftercare negligence will be done at my own expense.

I understand i am making permanent changes to my body.

i am not pregnant or nursing.

i understand any wound has the possibility of getting an infection and that i have been advised of the signs and symptoms of infection (redness, swelling, pain, warmth, pus or fluid drainage, and potentially fever or red streaks radiating from the injury)

i understand that if i have diabetes, i agree to get a medical note from my doctor confirming i am fit to be tattooed.

final consent *

I have been fully informed of the risks of tattoo aplication. Having been informed, i wish to proceed with the appointment and i assume any and all risks that may arise.