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Tattoo Release Form

Let us do this part
Today's Date:
Sat Jun 14 2025 02:50
Practitioner:*
Tattoo Design:*
Tattoo Location:*
Tattoo Price:*
Color(s) Used:*
Catalogue #:*
Paramount Tattoo & Piercing
1020 W. Magnolia Ave.
Fort Worth, TX 76013
(817) 876-2499
Photo ID*
Please take photo(s) of your government issued photo IDs and related paperwork.
Please read and answer
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I acknowledge by signing this agreement that I have been given the full opportunity to ask any and all questions which I might have about the obtaining of a tattoo and that all of my questions have been answered to my full satisfaction. I specifically acknowledge I have been advised of the facts and matters set forth below and I agree as follows:
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If I have any condition that might affect the healing of this tattoo, I will advise my tattooer.
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I am not pregnant or nursing.
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I am not under the influence of alcohol or drugs.
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I do not have medical or skin conditions such as but not limited to: acne, scarring (Keloid) eczema, psoriasis, freckles, moles or sunburn in the area to be tattooed that may interfere with said tattoo. If I have any type of infection or rash anywhere on my body, I will advise my tattooer.
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I acknowledge it is not reasonably possible for the representatives and employees of this tattoo shop to determine whether I might have an allergic reaction to the pigments or processes used in my tattoo, and I agree to accept the risk that such a reaction is possible.
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I acknowledge that I do not have a heart condition; epilepsy; or hemophilia.
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I acknowledge that today and 6 months prior to today I am or have have not been infected with jaundice, hepatitis, or HIV/ AIDS.
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I acknowledge that infection is always possible as a result of the obtaining of a tattoo, particularly in the event that I do not take proper care of my tattoo. I have received aftercare instructions and I agree to follow them while my tattoo is healing. I agree that any touch-up work needed, due to my own negligence, will be done at my own expense.
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I realize that variations in color and design may exist between any tattoo as selected by me and as ultimately applied to my body.
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I understand that if I have any skin treatments, laser hair removal, plastic surgery or other skin altering procedures, it may result in adverse changes to my tattoo.
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I acknowledge that a tattoo is a permanent change to my appearance and that no representations have been made to me as to the ability to later change or remove my tattoo. To my knowledge, I do not have a physical, mental or medical impairment or disability which might affect my well being as a direct or indirect result of my decision to have a tattoo.
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I acknowledge I am over the age of eighteen and that I have truthfully represented to my tattooer that the obtaining of a tattoo is by my choice alone. I consent to the application of the tattoo and to any actions or conduct of the representatives and employees of the tattoo shop reasonably necessary to perform the tattoo procedure.
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I agree for myself, my heirs, assigns, and legal representatives to release and forever hold harmless Paramount Tattoo & Piercing from any and all claims, damages or legal actions arising from or connected in any way with the tattoo or procedures and conduct used to apply my tattoo.
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I give permission to use of my photos for the purpose of marketing. My pictures may appear in print or online. I hereby grant the Paramount Tattoo & Piercing permission to use my likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration.
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I understand that the Return Policy states that all sales are final on all services and products. There are no exchanges or returns will be accepted, and refunds will not be issued.
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I have received a copy of applicable written care instructions, and I have read and understand such written care instructions.
You are hereby notified of the possible risks or dangers associated with the application of each tattoo and or tattoo session. These risks and dangers include, but are not limited to at least the following:
1. The possibility of discomfort or pain;
2. The permanence of the markings;
3. The risk of infection;
4. The possibility of allergic reaction to the pigments or other materials used


An artist may not tattoo a person younger than 18 years of age without meeting the requirements of 25 Texas Administrative Code, §229.406(d), whose parent or guardian determines it to be in the best interest of the minor child to cover an existing tattoo.

The client shall consult a health care practitioner at the first sign of infection or
an allergic reaction, and report any diagnosed infection, allergic reaction, or adverse reaction resulting from the body piercing to the artist and to the Texas Department of State Health Services, Tattoo and Body Piercing Program, at (512) 834-6711.
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.
Name:*
Address:*
Postcode:
Date of birth:*
You must be 18 or older
Gender:
Phone #:*
Email:*
Signature:*