tattoo consent
CLIENT DETAILS
Name
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First
Last
Preferred Name
Date of Birth
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CLIENT DETAILS
Email
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Phone
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Drivers License Number
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Licence Expiry Date
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CLIENT DETAILS
Please select 'yes' or 'no' to the following if they apply to you. Please note that answering ‘yes’ to any of these questions does not necessarily exclude you from receiving a tattoo
Cancer
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Yes
No
Diabetes
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Yes
No
Bruising or swelling
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Yes
No
Blood thinners or Pain medication
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Yes
No
HIV/AIDS or any other blood borne diseases
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Yes
No
Hepatitis
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Yes
No
Are you under the influence or drugs or alcohol?
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Yes
No
Are you pregnant or breastfeeding
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Yes
No
Latex allergy
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Yes
No
Other allergy
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Yes
No
Prone to fainting
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Yes
No
Prone to bleeding or high/low blood pressure
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Yes
No
Have you eaten in the last 4 hours?
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Yes
No
If you answered 'yes' to any of the above, please elaborate
I HAVE READ THE BELOW AND AGREE
To induce Inklaid Tattoo to tattoo me and in consideration of its doing so, I hereby release the tattoo studio, the tattoo artist and any employees and associates thereof from all manner of liabilities, claims, actions and demands, in law or in equity, which I or my heirs have or might have now or hereafter by reason of complying with my request to have a tattoo procedure performed.
I understand that any employee or agent of this studio when performing a tattoo does not act in the capacity of a medical professional. The suggestions made by any employee or agent of the studio are not to be construed or substituted for advice from a medical professional.
I understand I will be tattooed using appropriate instruments and techniques. To ensure proper healing of my tattoo, I agree to follow the aftercare instructions outlined in the written tattoo aftercare instructions provided to me until healing is complete. (Please see https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/tattoos)
I assume full responsibility for aftercare and cleanliness as I have read and fully understand the aftercare instructions. I agree that any touch-up work needed, due to my own negligence, will be done at my own expense. This includes any tattoos on fingers/ hands/ palms/ feet & ears, as I have been duly informed that these areas are physiologically predisposed to the dropping out, fading and/or blurring of ink.
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 studio is responsible for the meaning/ spelling of the symbol or lettering that I have provided them or have chosen from flash design sheets.
I understand that by having this tattoo performed I am making permanent change to my body and no claims have been made regarding the ability to undo changes made.
** YOU MUST BE AT LEAST 18 YEARS OLD **
Signature
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Todays Date
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