Let’s work together

Name *

First Name

Last Name

Phone

(###)

###

####

DOB *

Please be prepared to show proof of age - ID has to be a photo ID.

MM

DD

YYYY

What services are you receiving today? *

Tattoo

Piercing

Signed...

You acknowledge by signing this agreement that you have been given the full opportunity to ask any questions which you might have about obtaining a tattoo/piercing and that all your questions have been answered. You acknowledge that it is not reasonably possible to determine whether you might have an allergic reaction to the pigments jewellery or the process used in your tattoo/piercing and you agree to accept that such risk is possible. You acknowledge that there may be a risk associated with the ink products used in tattooing and that such inks may contain substances which are potentially harmful to your health. You understand that discrepancies in colour between the design and the final tattoo can occur due to skin types and care of the tattoo. You declare that you give your full consent to the tattoo/piercing being carried out by the operator. I confirm that potential complications. e.g infection and swelling, for the procedure undertaken are always possible, particularly in the event that you do not take proper care of your tattoo/piercing. You confirm that the aftercare instructions have been explained to you and that it is your responsibility to follow the aftercare advice until the site is healed.

By ticking this box you are electronically confirming that the above information provided is correct to the best of your knowledge, that you are over 18 years of age and that you are not currently under the influence of drugs or alcohol.

Todays date... *

MM

DD

YYYY

Name of chosen artist...

Rachel

Sam

Richard

Tom