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You have requested a tattoo that involves minor breakage of the skin surface with a needle. This process may complicate some medical conditions.

Please read the following information carefully, if any of these conditions apply to you then please discuss them with your tattoo artist prior to having your tattoo.

Medical Condition

• Eczema, psoriasis, acne, cellulitis or any other skin condition
• Heart disorder
• High/low blood pressure
• Hemophilia or other bleeding disorders
• Epilepsy or other form of seizures
• Diabetes
• Hepatitis
• Autoimmune Disease or treatment causing it
• Allergies, especially nickel allergy
• Pregnant or nursing mother
• Medication
• Any other condition

I acknowledge by signing this agreement that I have been given the opportunity to ask questions, make adjustments and that all my request were granted during my consulation with my chosen artist.

That I am not under the influence of alcohol or drugs.

That I am definitely over 18 and have showed ID to prove this.

That I accept the risk of possible reactions to pigments or processes used and that it is not reasonably possible for the artist to determine beforehand whether or not I will have a reaction.

That infection is always possible, particularly when the correct aftercare procedures are not followed. Any work needing touched up due to negligence will be done at my own expense.

There may be differences and variations between the orginal design and my tattoo due to pigmentation in the skin. (i.e. Ink will appear bolder on pale skin with less variation on darker skin)

That skin or laser treatments may result in adverse changes to my tattoo. (i.e. Plastic surgery or laser removal)

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

Consent form completed.

Return to staff and enjoy your new tattoo!