Still Gold Tattoo

Do you have any Flu like symptoms?*

IF YOU HAVE:
- a fever
- flu-like symptoms
- shortness of breath

PLEASE NOTIFY A STAFF MEMBER IMMEDIATELY.

Eaten*

Have you eaten in the past few hours? We recommend eating 2-4 hours before hand to increase your blood sugar levels.

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.

Duress*

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.

Allergies/ Reactions

Do you have, or have you in the past, had any allergies/adverse reactions to latex/pigments/dyes/disinfectant/soaps/metals/numbing products? If yes, please list them below:

Details:

Medical Conditions*

I affirm that I informed the artist, of any medical conditions such as: diabetes, epilepsy, hemophilia, a heart condition or take blood thinning medication. I do not have any other medical or skin conditions that may interfere with the procedure or healing of the tattoo. I am not pregnant or nursing. I do not have a mental impairment that may affect my judgment in getting the tattoo.

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.

Design/ Longevity *

Variations in color/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.

Healing*

The Artist has given Me written and verbal aftercare 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, I agree that the work will be done at my own expense.

Risks*

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 but not limited to infection, scarring, 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.

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.

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/Reviews

I release all rights to any photographs taken of me and the tattoo or piercing and give consent in advance to their reproduction in print or electronic form for advertising/ promotional purposes. I also release the rights to any possible reviews I may write in regards to my body art procedure that may also be used for advertising/ promotional purposes. (If you do not tick this provision, please advise your Artist).

No Refunds

I understand that there are NO Refunds.

Correct Info

I hereby certify to the best of my knowledge, that the above information is correct.