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Tattoo Consent Form

To proceed with your tattoo appointment, please complete the consent form below and submit.

We are unable to undertake any tattoo’s without a completed consent form.

Fields marked with an (*) are mandatory.

Please enable JavaScript in your browser to complete this form.

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First Name *

Surname *

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Age *

Date of birth *

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Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

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Emergency Contact Name *

Emergency Contact Telephone *

Pre-Procedure Questionnaire

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Are you under the influence of drugs or alcohol? *

Yes
No

Are you pregnant or breast feeding? *

Yes
No

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Do you have any skin conditions? *

Yes
No

Please provide details

Do you have a communicable disease? *

Yes
No

Please provide details

Any medical history we should be aware of? e.g. Diabetes, Cardiovascular Disease, Epilepsy, Blood-related diseases etc.

Consent field 1 *

I understand that this procedure is a permanent change to my skin and body*

Consent field 2 *

I allow my tattoo to be photographed and be used for the shop / artist portfolio*

Consent field 2 *

I acknowledge that the shop does not offer refunds*

Consent field 3 *

I agree that the studio does not have a way to identify if I am allergic to the elements or ingredients that will be used for my tattoo*

Consent field 4 *

I understand that I need to take care of the tattoo by following the instructions given to me by the artist/shop*

Consent field 5 *

I understand that I might get an infection if I don’t follow the instructions given to me in regards of taking good care of my tattoo*

Consent field 6 *

I indemnify and hold harmless the shop/artist against any claims, expenses, damages and liabilities*

Consent field 7 *

I confirm that the information provided in this document is accurate and true*

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Date / Time *

Please Select

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Free UK delivery on orders over £50

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