Waive* I hereby give consent to my artist at Honey Ink to perform a tattoo and in consideration of doing so,

I hereby release the tattoo studio, and its employees and agents from all manner of liabilities, claims, actions and demands in law or in equity, which I or my heirs might now or hereafter by reason of complying with my request to be tattooed.

I fully understand that any employee or agent of this tattoo studio when performing a tattoo does not act in the capacity as a medical professional.

The suggestions made by an employee or agent of this studio are just suggestions. They are not to be construed as, or substituted for advice from a medical professional.

I UNDERSTAND THAT I WILL BE TATTOOED USING appropriate techniques, instruments and pigments.
To ensure proper healing of my tattoo, I agree to follow the written and/or verbal TATTOO aftercare instructions that will be provided until healing is complete.
I understand that a tattoo may take two weeks or longer to heal properly.

I WILLINGLY SUBMIT TO THESE PROCEDURES with a full understanding of possible complications such as but not limited to infection, allergic reaction or rejection of the ink.
Neither the artist nor the Tattoo Studio is responsible for the meaning or spelling of the symbol that I have provided to them or chosen from the flash design sheets.

I HAVE RECEIVED A COPY OF THE WRITTEN TATTOO AFTERCARE INSTRUCTIONS which I have read and fully understood and hereby assume full responsibility for aftercare and cleanliness. I understand that by having this tattoo performed that I am making a permanent change to my body and no claims have been made regarding the ability to undo the changes made.

Health/Medical Procedure* (Y)Yes I do have,
(N)No, I do not have,

- Diabetes
- Epilepsy
- Hemophilia
- 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 have not had any major/minor surgical procedures and/or treatments in the last 6-12 months or currently on medications from a past procedure/treatment
- I am not the recipient of an organ or bone marrow transplant or, if I am, I have taken the preventive antibiotics.
- I do not have a mental impairment that may affect my judgment in getting the tattoo.

If you have ticked YES please advise your artist.

Fading & Meaning * (1) 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.

(2) I understand neither the artist nor the studio is responsible for the meaning or spelling/numbers of the tattoo and stencil placed i have agreed to

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 tick NO, please advise your Artist).

Numbing* Have you applied any numbing agents to the area being tattooed?

If yes, please explain type used and when applied

Bleeding * Are you prone to heavy bleeding?

Bloodbourne Pathogens* Do you have any bloodbourne pathogens, transmittable diseases or recent illnesses?

Influence* Have you had any alcoholic beverages in the last eight hours or under the influence of any drugs?

Food* Have you eaten in the past 4 hrs?

We recommend you have something to eat as It's a good idea to beforehand to increase your blood sugar levels, (Coffee and/or Energy drinks do not count as food)

Latex Allergy* Do you have a latex allergy? If yes, please let your artist know as we generally use latex gloves.

Known Allergies* Do you have any known allergies or skin sensitivities ?
If Yes, please let your artist know and list them all below.

(Some products we use in studio may contain Aloe Vera, Lavender, Witch Hazel, Honey, Leaf/Flower, Fruit Extracts and Oils just to name a few)

Blood Pressure* Do you have high blood pressure ?

Medication* Have you taken any forms of Medication(s) in the last 24 hours?

Including any
- Aspirin,
- Paracetamol,
- Ibuprofen,

or are on any current Antibiotics or Acne Medications?

Please list ALL current medications below.

Fainting * Are you prone to fainting? (Light headed and/or dizziness)
If yes, please let your artist know.

Pregnancy* I am not pregnant or breastfeeding. (Tick yes to say your are not)

Acknowledgement * (1) I acknowledge that the sterilisation method used was explained to my full satisfaction.
(2) I had the opportunity to ask questions regarding this procedure.
(3) All questions were answered to my satisfaction.
(4) All equipment during the procedure was opened in front of me.
(5) I witnessed the disposal of the tattoo needle(s) into regulated sharps containers.
(6) Both written and verbal Tattoo Aftercare Instructions were provided to me.
(6) I have read this Tattoo Consent & Release Form and confirm that all the information I have given is correct.
(7) I understand that this is a release form and I agree to be legally bound by it.

Emergency * In the event that the practitioner reasonably believes emergency medical assistance is required,
I authorise the practitioner and/or studio staff to contact emergency services (000) and seek appropriate medical treatment on my behalf.


I understand that any costs associated with ambulance transport, hospital treatment, medical assessment, or other healthcare services are my responsibility.

And consent to have your emergency contact contacted on your behalf?