Tattoo Waiver Form

Name *

First Name

Last Name

I consent to getting tattooed and have been fully informed of the inherent risks associated with getting a tattoo. I fully understand that these risks, known and unknown, and lead to injury; including but not limited to infection, scarring, difficulties in detecting melanoma and allergic reactions to tattoo pigment and/or soap. *

Yes

Having been informed of the potential risks associated with getting a tattoo, I still wish to proceed with the tatto application and I freely accept and expressly assume any and all risks that may arise from tattooing. *

Yes

I waive and release to the fullest extent permitted by law each of the artist and tattoo studio from all liability whatsoever , for any and all claims or causes of action that I, my estate, heirs, executors or assigns may have for personal injury or otherwise, including any direct and/or consequential damages, which result or arise from the application of my tattoo, whether caused by the negligence or fault of either the artist or the tattoo studio, or otherwise. *

Yes

Have you consumed any drugs or alcohol within the last 24hrs ? *

Yes

No

Will/ Have you eaten anything in the past 4 hrs prior to your tattoo? *

Yes

No

Are you allergic to anything? *

Yes

No

Do you have diabetes, epilepsy, hemophilia, a heart condition, asthma, emphysema, thyroid condition, high blood pressure, mitral vale prolapse, psoriasis, eczema, skin rashes, vitiligo, hives? *

Yes

No

Other

Do you have HIV, Hepatitis, Staphylococcal (Staph) Infections, or any other blood borne pathogen that could be transmissible through exposure to blood. *

Yes

No

Other

Are you pregnant or nursing? *

Yes

No

Do you have a mental impairment that may affect your judgment in getting a tattoo? *

Yes

No

Are you prone to fainting or light headedness? *

Yes

No

Have you ever been tattooed professionally before? *

Yes

No

I understand that a foreign substance is being put into my body an I may have a reaction to that substance. *

Yes

No

I understand that neither the artist, nor the tattoo studio is responsible for the meaning or spelling of te symbol or text that I have provided to them or chosen from them or requested to be drawn. *

Yes

No

I understand variations in colour and design may exist between the tattoo art I have selected and thee actual tattoo when it is applied to my body. I also understand that over time, the colours and clarity of my tattoo will fade due to unprotected exposure to the sun and the naturally occurring dispersion of pigment under the skin. *

Yes

No

I understand that a tattoo is a permanent change to my appearance. *

Yes

No

Any questions or concerns that I have regrding sterilization, the procedure, my tattoo was answered and explained to my full satisfaction. I hold the right to request that all equipment be set up in front of me as well as to witness the disposal or any sharp(s) into appropriate medical waste containers. *

Yes

No

The artist and the tattoo studio have given me instructions on the care of my tattoo whiole 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. *

Yes

No

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 expense. *

Yes

No

I agree to sit for 15 minutes prior to the completion of my tattoo. *

Yes

No

I give consent to photos taken of me and my tattoo, and allow the artist and studio to take photos and post them to social media, print them into portfolios. *

Yes

No

I acknowledge that I have been given adequate opportunity to read and understand this document, and I understand that I am signing a legal contract waiving certain rights to recover against the artist and the tattoo studio. *

Yes

No

I herby declare that I am of legal age and have provided valid proof of age and am competent to sign this agreement. *

Yes

No

Phone

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country