Prior to any tattoo procedure you will need to read and sign this consent form. A copy will be emailed to you when you book an appointment or you can download a copy from the button on the bottom of this page. If you have any questions, please address them with your tattoo artist prior to your tattoo services. Fill out the first line and the bold.

NAME: ____________________________________ DATE: _________ PHONE: (___)____________

DOB: ______________________________________ LICENSE#: _____________________ TYPE (STATE):________

ADDRESS: ____________________________ CITY: _________________ STATE: ____ ZIP: _______

I acknowledge by signing this agreement that I have been given the full opportunity to ask any and all questions which I might have about the obtaining of a tattoo and all my questions have been answered to my full satisfaction. I specifically acknowledge I have been advised of the facts and matters set forth below and I agree as follows:

• If I have any condition that might affect the healing of this tattoo, I will advise my tattooer and note them in the margin. I am not pregnant or nursing. I am not under the influence of alcohol or drugs.
• I do not have a medical condition such as but not limited to: epilepsy, hepatitis, AIDS or any other infectious disease.
• I do not have a medical condition that weakens my immune system, such as but not limited to: diabetes, which may put me at increased risk for infection.
• I am not on medication that would thin my blood and I am not a hemophiliac or prone to excessive bleeding.
• I do not have a 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 said tattoo. If I have any type of infection or rash anywhere on my body, I will advise my tattooer and note it in the margin of this document.
• 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, medical supplies or processes used in my tattoo, and I agree to accept the risk that such a reaction is possible.
• I acknowledge that infection is always possible as a result of the obtaining of a tattoo, particularly in the event that I do not take proper care of my tattoo. I have received aftercare 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 the process of tattooing involves the possibility of discomfort or pain.
• I realize that 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 understand that if I have any skin treatments, laser hair removal, plastic surgery or other skin altering procedures, it 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 acknowledge I am over the age of 18 and that I have truthfully represented to my tattooer that the obtaining of a tattoo is by my choice alone. I consent to the application of the tattoo and to any actions or conduct of the representatives and employees of the tattoo shop reasonably necessary to perform the tattoo procedure.
• I agree to release and forever discharge and hold harmless the Tattoo Artist and all employees from any and all claims, damages or legal actions arising from or connected in any way with my tattoo, or the procedure and conduct used in his/her tattoo procedure.
• I have been provided with written care instructions and have read and understand the instructions.

CLIENT: ________________________________________ DATE: _________________________________

TATTOO: _______________________________________ LOCATION:_______________ COLOR: _____________

TATTOOER: ____________________ DATE: ____________________________________ COLOR: _____________