[Studio name] · Tattoo consent and release form
Client details
- Full name: ______________________________
- Date of birth: ____________ Phone: ____________________
- Email: ______________________________
- Photo ID checked (type and last 4 digits): ______________
- Emergency contact (name and phone): ______________________
Health questions
- Please answer yes or no. Tell your artist about anything that could affect your tattoo or healing.
- Allergies (inks, pigments, latex, adhesives, soaps, medication): Yes / No — details: ____________
- Skin conditions at or near the tattoo area (eczema, psoriasis, keloids): Yes / No
- Diabetes, heart condition, epilepsy, hemophilia or a blood-borne condition: Yes / No
- Taking blood thinners or medication that affects healing: Yes / No
- Pregnant or breastfeeding: Yes / No
- Had alcohol or recreational drugs in the last 24 hours: Yes / No
- Eaten in the last four hours: Yes / No
The tattoo
- Design and placement: ______________________________
- Artist: ____________________ Session: ___ of ___
- I have checked the spelling, size and placement of the design and approve it.
I understand that
- A tattoo is a permanent change to my skin, and removal is difficult, costly and may not be complete.
- Colors can look different on my skin and will change over time and as it heals.
- There is a risk of infection, allergic reaction and scarring, even when aftercare is followed.
- I have received aftercare instructions and will follow them. Healing is my responsibility.
- [Studio name] uses single-use needles and follows hygiene practices required by local regulations.
Deposits and cancellations
- My deposit of $______ is applied to this project.
- If I cancel or move my appointment with less than ___ hours' notice, the deposit may be kept by the studio.
Photos
- I agree that photos of my tattoo may be used in the artist's and studio's portfolio: Yes / No
Signatures
- I confirm I am 18 or older, the information above is true, and I agree to be tattooed.
- Client signature: ______________________ Date: ____________
- Artist signature: ______________________ Date: ____________