Tattoo Consent Form

←

Let us do this part

Today's Date:

Fri Apr 26 2024 12:40

Practitioner:*

Ebony Squid Studio Consent Form

Please read and answer

Appointment Preamble*

Do you confirm that you have read the preamble sent to you by the studio in full, and agree to abide by all of the instructions therein?

Over 18?*

Do you confirm that you are over the age of 18?

Payment*

Do you confirm that you will pay the full balance of the tattoo via bank transfer before attending the studio for your appointment?

Please note: Paypal is no longer being accepted at Ebony Squid Studio, and if full payment is not made before attending your appointment then the tattoo cannot go ahead.

Food and Drink*

Do you confirm that you will eat a good dinner the night before your appointment and a good breakfast the morning of?

Please make sure to bring a selection of snacks and sugary drinks with you to your appointment to consume throughout the day.

Medical checklist*

Do you confirm that you do not have diabetes, epilepsy, haemophilia, a heart condition, anything requiring blood thinning medication, or any other medical condition that may effect the application of or healing of your tattoo?

If you have any of these conditions please provide details.

Details:

Blood borne Pathogens*

Do you confirm that you do not have any blood borne pathogens? For example Hepatitis/HIV

(It’s ok if you do but we must be made aware before you attend the studio for your, and our own, safety.

Allergies*

Do you confirm that you do not have any allergies that may effect you being tattooed?

If you have any allergies please provide details.

Details:

Risks*

I confirm that I understand there are inherent risks associated with getting tattooed and I still wish to proceed with the tattoo application and freely accept and expressly assume any and all associated risks.

Waive Liability*

I agree 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 may have for personal injury or otherwise. This includes any direct and/or consequential damages which result or arise from my tattoo procedure.

Healing*

I confirm that I will accept the aftercare instructions given to me by the studio and follow these instructions while it is healing. I acknowledge that it is possible that the tattoo can become infected, particularly if I do not correctly follow the instructions given to me. If any touch up work is needed due to my own negligence, decided at the discretion of the artist, then I agree that the touch up work will be completed at my own expense.

*** Please note: Touch ups are only free at the artist's discretion, and only when booked within 3 months of the original tattoo having been completed ***

Pregnancy/Nursing*

I confirm that I am not pregnant or nursing a child.

Spelling*

I confirm that neither the artist or the studio is responsible for the spelling of any text that I have provided for them, and I confirm that I am entirely responsible for checking that any spellings included in the design are correct before the tattoo begins.

Permanence *

I understand and accept that this tattoo is a permanent change to my skin. I also accept that the tattoo will naturally change and fade over time and that this can be exacerbated by my not taking the appropriate steps to care for my tattoo, such as not getting sun tanned or burnt in that area.

Photos*

I consent for any photographs taken by the artist to be used for their social media or promotional purposes by the artist and the studio.

Alcohol/Drugs*

I confirm that 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.

Covid-19*

I confirm that I have complete, or will complete, the Covid-19 consent form provided to be by the studio alongside this form before I attend the appointment.

Please note: You will not be given access to the studio unless you have completed this Covid-19 form.

Where did you hear about us?*

All of the above information will be held in the strictest confidentiality.

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:*

Pronoun:

Chosen name:

Address:*

Postcode:*

Date of birth:*

You must be 18 or older

Phone #:*

Email:*

Signature:*

Sign above or type signature:

Emergency Contact

If something happens, your emergency contact might need to explain your medical history, allergies, or medications.

Name:

Phone #:*

Photo ID*

Please take photo(s) of your government issued photo IDs and related paperwork.