TATTOO CONSENT
In this form, you give consent to have a tattoo applied to your body. You also confirm that you are aware of the risks or medical exclusions mentioned in this form. Please read the form carefully before confirming it at the end.
First Name*
Last Name*
Email*
Phone*
date of birth
Parent/guardian (not applicable for 18+)
1. INFORMATION FOR THE CLIENT ACCOMPANYING THE CONSENT FORM
Please, read the following information carefully and inform the tattoo artist if you have any doubts about your eligibility to be tattooed. Tattooing and the healing process can come with risks and potential complications as explained to you. You will be given instructions on aftercare to help you minimize the effects. It is normal for tattooing to be accompanied by pain, redness and swelling. If these symptoms worsen during the healing process, it could be a sign of infection and you see a doctor. Some complications may be related to your health situation. It is important for your safety that the tattoo artists is informed of this. Additional precautions may be necessary. Tattoos are permanent and, depending on the ink used, they may not be able to be removed properly. If in doubt, treatment should be delayed and medical advice should be sought.
DO NOT GET A TATTOO
1. If you are pregnant or breastfeeding.
2. If you are under the influence of alcohol and/or drugs.
3. On a birthmark or a scar left after a melanoma has been removed.
THE FOLLOWING CONDITION OR CONDITIONS MAY PUT YOU AT A HIGHER RISK OF COMPLICATIONS (please select the box if applicable to you)
Skin infections, regardless of location and type of infection.
Allergies, please specify if you have an allergy. E.g. latex, metals or preservatives.
Areas of skin that appear damaged or abnormal, including moles.
Any skin diseases that are active. E.g. eczema, psoriasis.
Skin areas that have been subjected to plastic surgery or radiotherapy including recent scars and keloids (according to medical advice).
A previously tattooed spot that has not yet healed.
Haemophilia, or any other coagulation disorder.
Epilepsy, cardiovascular disease, diabetes, any autoimmune disease, sarcoidosis.
Immunosuppression and immune compromised disorders.
IF ANY OF THE ABOVE CONDITION OR CONDITIONS APPLY TO YOU AND YOU STILL WANT A TATTOO, PLEASE CONSULT YOUR DOCTOR FIRST AND SEEK ADVICE.
Client statement
I have considered the information under point 1.
I have been informed about the possible risks and complications associated with placing the tattoo and understand the information.
I am not currently under the influence of alcohol and/or drugs and/or any other substance, to be able to influence my experience, free will and judgement.
The aftercare procedure has been clearly explained to me and I understand what actions I should take, should perform and what precautions I should take.
I have been given my own copy of the aftercare instructions.
I give permission for the tattooing as described under point 5.
I am aware of and accept the risks and possible complications associated with getting tattooed.
I confirm that the tattoo artist may keep this consent form on file.
I confirm that I have given the information and statements on this consent form to the best of my knowledge and belief they are correct.
I, client as named above, agree with the contents of this consent form. I have filled in this consent form honestly and to the best of my ability
Yes
No
Filled in by tattoo artist from here
Tattoo discription
Ink brand
Ink type and color
Ink distributor
Ink batch number
Needles used
Tattoo artist statement
I confirm that tattooing is carried out under hygienic conditions with suitable sterile instruments and safe techniques and according to EN 17169 and that corresponding national requirements are implemented.
I confirm that the client has been presented with a copy of this signed consent form and that the client has been advised to retain the information.
I, tattoo artist as named above, proclaim that this form as been filled in correctly and to the best of my ability
yes
no
SUBMIT YOUR CONSENTFORM