Tattoo Consent Form Date: Full Name: Drivers License Number: Address: Phone Number: Birthday: Signature Artist Signature I acknowledge by signing this agreement that I have been given full opportunity to ask questions about obtaining a tattoo and that all of my questions have been answered to my satisfaction. I specifically acknowledge that I have been advised and agree to the following: If I have any conditions that might affect the healing of my tattoo, I will advise my artist. I am not pregnant, nursing or under the influence of drugs or alcohol. I do not have any medical or skin conditions such as but not limited to: acne, scarring(keloid), eczema, psoriasis, freckles, moles or sunburn in the area to be tattooed that may interfere with the tattoo. I acknowledge that it is not possible for the employees of Doing Tattoo to determine whether I might have an allergic reaction to the pigments or processes used in my tattoo, and I accept the risk the such a reaction is possible. I acknowledge that an infection is always possible as a result of obtaining a tattoo, particularly if I do not take proper care of my tattoo. I have received after care instructions and I agree to follow them while my tattoo is healing. I agree that any touch-up work needed, due to my own negligence, will be done at my own expense. I acknowledge that a tattoo is a permanent change to my appearance and that no representations have been made to me about the ability to change or remove my tattoo. This may affect my well being as a direct or indirect result of my decision to have a tattoo. I acknowledge that I am over the age of 18 and that I have truthfully represented to my artist that the obtaining of a tattoo is by my choice alone. I consent to the application of the tattoo and to any actions by the employees of Doing Tattoo reasonably necessary to perform the tattoo procedure. I understand that the photographs may be used in publication, print advertisement, direct mail piece, electronic media or other forms of communication. I hereby relinquish any and all personal or proprietary rights I may have in connection with such use. I understand that I will receive no compensation should any photos of me be used. I hereby release, Doing Tattoo Inc., its affiliates, officers, directors, agents, employees and contractors from liability for any injury, loss or damage that may result from my use of equipment or from any services provided or treatment rendered. This release binds my heirs, successors and assigns.

tattoo consent form · I acknowledge that I am over the age of 18 and that I have truthfully represented to my artist that the obtaining of a tattoo is by my choice alone. I consent

Download PDF Report

Upload
others
View
0
Download
0

Embed Size (px)

Citation preview

Page 1: tattoo consent form · I acknowledge that I am over the age of 18 and that I have truthfully represented to my artist that the obtaining of a tattoo is by my choice alone. I consent

Tattoo Consent FormDate:

Full Name:

Drivers License Number:

Address:

Phone Number:

Birthday:

Signature Artist Signature

I acknowledge by signing this agreement that I have been given full opportunity to ask questions about obtaining a tattoo and that all of my questions have been answered to my satisfaction. I specifically acknowledge that I have been advised and agree to the following:

If I have any conditions that might affect the healing of my tattoo, I will advise my artist. I am not pregnant, nursing or under the influence of drugs or alcohol.

I do not have any medical or skin conditions such as but not limited to: acne, scarring(keloid), eczema, psoriasis, freckles, moles or sunburn in the area to be tattooed that may interfere with the tattoo.

I acknowledge that it is not possible for the employees of Doing Tattoo to determine whether I might have an allergic reaction to the pigments or processes used in my tattoo, and I accept the risk the such a reaction is possible.

I acknowledge that an infection is always possible as a result of obtaining a tattoo, particularly if I do not take proper care of my tattoo. I have received after care instructions and I agree to follow them while my tattoo is healing. I agree that any touch-up work needed, due to my own negligence, will be done at my own expense.

I acknowledge that a tattoo is a permanent change to my appearance and that no representations have been made to me about the ability to change or remove my tattoo. This may affect my well being as a direct or indirect result of my decision to have a tattoo.

I acknowledge that I am over the age of 18 and that I have truthfully represented to my artist that the obtaining of a tattoo is by my choice alone. I consent to the application of the tattoo and to any actions by the employees of Doing Tattoo reasonably necessary to perform the tattoo procedure.

I understand that the photographs may be used in publication, print advertisement, direct mail piece, electronic media or other forms of communication. I hereby relinquish any and all personal or proprietary rights I may have in connection with such use. I understand that I will receive no compensation should any photos of me be used.

I hereby release, Doing Tattoo Inc., its affiliates, officers, directors, agents, employees and contractors from liability for any injury, loss or damage that may result from my use of equipment or from any services provided or treatment rendered. This release binds my heirs, successors and assigns.