An electronic tattoo shop waiver for tattoo

TATTOO ARTIST

JAY BLUMFIELD

BRAYDAN BLUMFIELD

TALEIYA BROWN

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to tattoo my Please enter your answer here.

and in consideration of his/her doing so,I hereby release the tattoo/piercing studio, and its employees and agents, from all manner of liabilities, claims, actions and demands, in law or in equity, which I or my heirs have or might have now or hereafter by reason of complying with my request to be tattooed.

I FULLY UNDERSTAND THAT ANY EMPLOYEE or agent of this studio when performing a tattoo does not act in the capacity of a medical professional. The suggestions made by any employee or agent of the shop are just suggestions. They are not to be construed or substituted for advice from a medical professional.

I UNDERSTAND I WILL BE TATTOOED using appropriate instruments and techniques. To ensure proper healing of my tattoo, I agree to follow aftercare suggestions outlined in the written aftercare instructions provided to me until healing is complete. I understand that a tattoo usually takes 2 weeks or longer to heal.

I WILLINGLY SUBMIT TO THESE PROCEDURES,with a full understanding of possible complications such as, but not limited to, infection, allergic reaction or rejection of the ink. Neither the Artist nor the Tattoo studio is resposible for the meaning or spelling of the symbol that I have provided to them or chosen from the flash (design) sheets.

I HAVE RECEIVED A COPY OF WRITTEN AFTERCARE INSTRUCTIONS, which I have read and fully understand and hereby assume full responsibility for aftercare and cleanliness. I understand that by having this tattoo performed that I am making a permanent change to my body and no claims have been made regarding the ability to undo the changes made.

I AM 18 YEARS OF AGE OR OLDER.

I HAVE SIGNED THIS RELEASE ON

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PLEASE ANSWER THE FOLLOWING QUESTIONS SO THAT WE MAY BETTER SERVE YOU

Have you eaten within the last 4 hours? *

YES

NO

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Have you had any alcoholic beverages in the last 8 hours? *

YES

NO

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Are you prone to fainting *

YES

NO

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Are you prone to heavy bleeding? *

YES

NO

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Do you have to take antibiotics before seeing the dentist? *

YES

NO

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Have you take aspirin,ibuprofen, or blood thinners in the last 24 hours? *

YES

NO

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Do you have any allergies? *

YES

NO

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If YES, what? Please enter your answer here.

Are you pregnant or breastfeeding? *

YES

NO

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Do you have any other conditions which might affect the healing of this tattoo? *

YES

NO

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If YES,what? Please enter your answer here.

How did you hear about us? Please enter your answer here.

PLEASE FILL IN THE FOLLOWING INFORMATION

I release all rights to any photographs taken of me and the tattoo and give consent in advance to the reproduction in print or electronic form. *

YES

NO

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Please Enter Date *

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First and last name: * Please enter your name.

Please fill in Address:

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Select Your Country: Please select one here.

Phone number: * Please enter your phone number.

Date of Birth: *

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Photo ID provided *

YES

NO

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Your Signature *

Click to sign

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