Consent Form

Please fill out the consent form below if this is your first tattoo with your chosen tattoo artist.

The form and answers within it are completely confidential.

Consent Form

First name

Last name

Date of Birth * required

Address

Tattoo placement

Please tick the following if they apply:

I have eaten in the last 4 hours

I have not consumed drugs or alcohol in the last 12 hours

My blood pressure is regular

I do not have any conditions, nor am I on any medication that compromises my immune system

I have never suffered from hepatitis A, B, or C

I am not allergic to antibiotics or the penicillin family of drugs

I am not diabetic, or if I am, I have discussed the tattoo procedure with my GP

I do not have any blood clotting disorders

I am not pregnant or breast feeding

I do not suffer from any form of seizure causing condition

I am not prone to dizziness or fainting

I understand that every care has been taken to ensure that this procedure has been carried out in a hygienic manner, and the aftercare of the tattoo is my sole responsibility

I understand that reaction to the pigments is still possible, even after the tattoo has healed

I understand that the artist is self employed and I will follow the aftercare advice given to me by my artist

I do not have any symptoms of COVID 19

Potential Risks

I confirm that I understand the following associated risks with tattooing:

Scarring
Allergic reaction
Localised swelling
Localised infection
Blood poisoning

The following MUST be read and accepted before submitting this form: * Required

The chances of the above risks are minimal, but I declare that I fully understand said risks and consent to the tattoo procedure.

I confirm that the health information provided by me for this consent form is correct to the best of my knowledge, that I am over the age of consent for this procedure (18), and I am not under the influence of alcohol or drugs.

As this procedure involves the breakage of skin with a needle I understand the health risks, and I am therefore obliged by law to declare any conditions that will affect this procedure. If you are unsure - ask your artist.

Your Signature

Artist Signature

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