Are you sick? * IF YOU HAVE:
- a fever
- flu-like symptoms
- shortness of breath
- cough
- runny nose
- stomach bug
- vomiting in the last 24 hours

YOU NEED TO NOTIFY A STAFF MEMBER IMMEDIATELY.

Wearing a face covering/mask does not excuse the severity of the illness. If you are sick at your appointment, you will be asked to leave and forfeit your deposit. We take the health of our clients and artists very seriously. If you have any illnesses or symptoms please notify a staff member and reschedule your appointment for when you're feeling better!

Consent * I hereby consent and authorize Hellebore Tattoo and all artists at the studio to perform the following service(s): Tattoo, and to waive and release to the fullest extent permitted by law each of the artists and the studio from all liability whatsoever. I have voluntarily elected to undergo this service/procedure after the nature and purpose of this treatment has been explained to me. I understand my artist and I will have physical contact but strictly only for tattooing purposes.

Consent * I am over 18 and not under the influence of any drugs or alcohol, nor have I consumed any within the last 12 hours. I am not pregnant or nursing and desire to receive the indicated procedure/service. I am not on antibiotics or taking any blood thinning medications.

Risks * I understand and acknowledge that there are risks involved with the procedure I will be receiving. Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and complications, and I have had the opportunity to ask questions regarding these risks and other complications. 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.

Aftercare * I have read and understand the post-service home care instructions provided (will be emailed after completion of this form). I understand how important it is to follow all instructions available to me for post-service aftercare. I understand that not STRICTLY following suggested aftercare can affect my service and results. In the event that I have additional questions or concerns regarding my service or suggested home aftercare, I will consult Hellebore Tattoo immediately via email or text. I will seek medical attention if needed or recommended.

Health * I am not on antibiotics and I do not have diabetes, epilepsy, hemophilia, a heart condition, nor do I take blood thinning medication. I do not have any other condition that may interfere with the application or healing of the tattoo. I am not the recipient of an organ or bone marrow transplant or, if I am, I have taken the preventive anti-biotics. I am not pregnant or nursing. I do not have a mental impairment that may affect my judgment in getting the tattoo. I understand that my medical history can affect the procedure and healed results.

Hygiene Standards * I have been informed that the highest standards of hygiene is upheld and sterile and disposable supplies are used fresh for each client each visit.

Results * I recognize there are no guaranteed results and that independent results are dependent upon age, skin condition, aftercare, and lifestyle and there is a possibility that I may require further treatments of the treated areas to obtain the expected results at a possible additional cost. I understand there are no guaranteed results.

Results * I am aware that the results of the service can be affected by the following: medications, skin characteristics, personal PH balance of skin, alcohol/smoking, and aftercare. You must not workout or get sweaty for 1 week following your appt.

Spelling * I understand I am fully responsible for all misspelling, mistranslating, and/or grammatical errors. I will check over and approve the tattoo stencil to ensure accuracy, size, and placement before the procedure.

Movement * I understand that any sudden movement, fidgeting, or twitching could affect the outcome of my tattoo. I do not hold my artist liable for the final outcome if I am unable to sit still for the procedure.

Photography/Media * I grant and authorize Hellebore Tattoo to take, edit, alter, copy, exhibit, and publish video/audio/photo content taken of me and the service provided. I waive the right to inspect and approve the finished content. I waive the right to any royalties or other compensation for any such media.

Funds * I understand there are no refunds and all sales are final. I have seen a rough estimate of the cost of the tattoo prior to my appt.

18+ * I understand Hellebore Tattoo artists do not tattoo anyone under 18 regardless of parental consent.

Health Cont. * Please list allergies, medications, and any important medical history or diagnoses. If you have none, put none.

Parking * Hellebore Tattoo and it’s employees are not liable for parking issues or tickets given by City of Idaho falls for downtown parking.

Numbing * Have you used any numbing agents for your appointment?

Appointment Details * Date of scheduled appointment:

I have read and understand all of the above. * I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. I agree I will assume all risk and full responsibility for any and all injuries, losses which may be seen or unseen, side effects, or damages which might occur to me while I am undergoing this procedure or am at the location. I do not hold Hellebore Tattoo or artists responsible for any conditions that were present and disclosed or not disclosed at the time of this service/procedure, which may be affected by the service performed today.