Release and Consent Form

Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

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Please read: *

1. I am aware of the risks associated with receiving a tattoo. 2. I have asked any questions I may have about the process of receiving a tattoo, and the artist has answered all of my questions to my satisfaction. 3. I am at least 18 years old. 4. I am aware that the artist will give me complete instructions for the aftercare of my tattoo. I understand the importance of following these instructions and acknowledge that any consequences arising from my neglect of these instructions, including loss of ink or infection, are my responsibility. 5. I am in good health today, or I have informed the artist if I am not feeling my best. 6. I have eaten a meal before my session, and I understand that if I begin to feel faint and/or queasy, I will inform my artist immediately. 7. I am not impaired by drugs or alcohol. 8. I have spoken to my artist about the final design, asked all questions I may have, and agree to the design, sizing, placement, spelling, and all other inquiries pertaining to the final tattoo. 9. I understand that tattoos naturally change from the original fresh design and may blur or fade over time. A touch-up is free up to six months from finishing the tattoo, if deemed necessary by the artist. 10. I understand that allergic or other reactions to certain inks, ointments, bandages, or solutions are possible, and I will inform the artist of any allergies I have before we start the tattoo session.

I have read, understand and agree to all above

Please check if any of these apply to you.

Diabetes

Skin Conditions

Hemophilia

Heart Conditions

Pregnant or Currently Nursing

Recent or Upcoming Surgeries

Immune Deficiencies

Recent Injury or Infection

Prone to Infection or Scarring

Please Check if you are on any of the following medications:

Steroids

Antibiotics

Blood Thinners

Skin/Acne Medications

Date *

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