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Tattoo

Let us do this part
Today's Date:
Fri Aug 15 2025 10:56
Practitioner:*
Tattoo Location (body part):*
Please read and answer
Y
N
Do you have Flu like symptoms?*
IF YOU HAVE:
- a fever
- shortness of breath
- loss of taste or smell
- dry cough
- sore throat

YOU NEED TO NOTIFY A STAFF MEMBER IMMEDIATELY.
Y
N
Eaten*
Have you eaten in the past 4hrs? It's a good idea to before hand to increase your blood sugar levels. If not please get a sugary drink or snack.
Y
N
Payment*
Are you paying with cash? A cash payment is preferred but we can take bank transfers, Monzo or PayPal.
Select Yes if paying with cash!
Risks*
I agree that I have been fully informed of the inherent risks, associated with getting a tattoo. I fully understand that these risks, known and unknown, can lead to injury, including and not limited to infection, scarring, blowouts, lines ageing, getting thicker, fallout, difficulties in detecting melanoma and allergic reactions to tattoo pigment, latex gloves, and/or soap.
Having been informed of the potential risks, I still wish to proceed with the tattoo application and I freely accept and expressly assume any and all risks.
Influence*
I am not under the influence of alcohol or drugs, and I am voluntarily submitting to be tattooed by the Artist without duress or coercion.
Waive*
TO WAIVE AND RELEASE to the fullest extent permitted by law each of the Artist and the Studio from all liability whatsoever, for any and all claims or causes of action that I, my estate, heirs, executors or assigns may have for personal injury or otherwise, including any direct and/or consequential damages, which result or arise from my tattoo, whether caused by the negligence or fault of either the Artist or the Tattoo Studio, or otherwise.
Y
N
Bloodbourne Pathogens*
Do you have any bloodbourne pathogens, transmittable diseases or recent illnesses? (It' okay if you do, we just need to know for our and other's safety).
This includes;
Hepatitis B/C,
HIV
Healing*
The Artist and the Tattoo Studio have given me instructions on the care of my tattoo while it's healing, and I understand them and will follow them. I acknowledge that it is possible that the tattoo can become infected, particularly if I do not follow the instructions given to me. If any touch-up work to the tattoo is needed due to my own negligence, tattoo ageing and/or the natural healing process, I agree that the work will be done at my own expense.
Spelling*
Neither the Artist nor the Tattoo Studio is responsible for the meaning or spelling of the symbol or text that I have provided to them or chosen from the flash (design) sheets.
Fading*
Variations in colour/design may exist between the art I have selected and the actual tattoo. I also understand that over time, the colors and the clarity of my tattoo will fade due to natural dispersion of pigment under the skin.
Permanent*
A tattoo is a permanent change to my appearance and can only be removed by laser or surgical means, which can be disfiguring and/or costly and which in all likelihood will not result in the restoration of my skin.
Questions*
I acknowledge that I have been given adequate opportunity to read and understand this document, that any and all of my questions have been answered, that it was not presented to me at the last minute, and I understand that I am signing a legal contract waiving certain rights to recover against the Artist and the Tattoo Studio.
Photography
I release all rights to any photographs taken of me and the tattoo and give consent in advance to their reproduction in print or electronic form. (If you do not tick this provision, please advise your Artist).
Y
N
Numbing Creams/Sprays*
The artist is not legally allowed to apply any numbing creams or sprays onto the client. If you are using any numbing creams please state below what you are using.

Please note that the artist and tattoo studio is not liable in any way for any reaction or healing issues caused by the numbing cream.

Always be sure to do a patch test to ensure you have no adverse reactions to any sprays or creams you apply.

STATE NO if you have not used numbing cream
Details:
 
Y
N
Allergies*
Please state if you are allergic to the following:

Adhesives
Plasters
Any creams
Latex
Coconut Oil
Witch Hazel
Tea tree
Or anything else that has not been stated that we may need to be aware of.
Details:
 
Y
N
Pregnancy*
Are you pregnant?
Y
N
Diabetes*
Have you diabetes
Y
N
Fainting or dizziness/ seizure/ epilepsy *
Fainting or dizzy, seizures or epilepsy risks
Y
N
Blood thinning medication*
E.g aspirin
Details:
 
Y
N
Haemophilia*
Suffer from haemophilia
Y
N
Blood pressure *
High blood pressure or any heart conditions?
Details:
 
If any provision, section, subsection, clause or phrase of this release is found to be unenforceable or invalid, that portion shall be severed from this contract. The remainder of this contract will then be construed as though the unenforceable portion had never been contained in this document.
Client Information
I hereby declare that I am of legal age (with valid proof of age) and am competent to sign this Agreement.
Legal Name:*
Pronoun:
Chosen name:
Address:*
Postcode:
Date of birth:*
You must be 18 or older
Phone #:*
Email:*
Social Handle:
If you don't mind us tagging you in photos online
Signature:*


Emergency Contact
If something happens, your emergency contact might need to explain your medical history, allergies, or medications.
Name:
Phone #:*
Photo ID*
Please take photo(s) of your government issued photo IDs and related paperwork.