The Outer Circle
Let us do this part
Today's Date:
Sat Oct 17 2026 12:28
Practitioner:*
Tattoo location (on Body):*
Tattoo description (include any spelling of script if required:
Tattoo price quote:*
The Outer Circle consent form

Please complete this form.
If you have any questions about this form, please ask your artist or Amy at reception.
Please read and answer
Y
N
IF YOU HAVE:
- a fever
- flu-like symptoms
- shortness of breath

YOU NEED TO NOTIFY A STAFF MEMBER IMMEDIATELY.
 
Y
N
Have you eaten in the past 4hrs? It's a good idea to before hand to increase your blood sugar levels.
Y
N
Do you have cash or are you able to pay by card? We can also accept Bank transfer, just ask us for the details.
Y
N
Do you have any bloodbourne pathogens, transmittable diseases or recent illnesses? (It' okay if you do, we just want to know for our and other's safety).
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.
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, I agree that the work will be done at my own expense.
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.
Y
N
I do not have any medical conditions.

I do not have diabetes, epilepsy, haemophilia, 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 judgement in getting the tattoo.

If you have any of the above, please state in the box below.

Details: 
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.
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.
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.
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).
I understand that if i need a touch up in the first 30 days, i will be required to pay a minimum of a £20 set up fee, this fee will be waived if i am are booked in for another tattoo at the same time. Any touch ups after this time will be charged according to the artists hourly rate.
Thank you for completeing our consent form, if you have any questions, please let your artist know and we will be happy to help.

Once the consent form has gone through, check your email for aftercare advice and studio contact 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:*
Chosen name:
Address:
Postcode:*
Date of birth:*
 
You must be 18 or older
Age: 
Phone #:*
Email:*
Signature:*

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