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Tattoo Consent & Release form

Please fill out the following form.

Date of birth
Day
Month
Year
Have you eaten in the last four (4) hours?
No
Yes
Have you had any alcoholic beverages in the last eight (8) hours?
No
Yes
Have you taken aspirin, ibuprofen or blood thinners in the last twenty four (24) hours?
Yes
No
Are you prone to heavy bleeding?
Yes
No
Are you prone to fainting?
Yes
No
Are you pregnant or breastfeeding?
Yes
No
Do you have high blood pressure?
Yes
No
Do you have any other conditions which might affect the healing on this tattoo?
Yes
No
Do you have any other known allergies?
Yes
No

If yes, please specify in answer box below.

I hereby consent to

of Devoir tattoo, to perform a tattoo and in consideration of doing so, I hereby release the tattoo 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 might now or hereafter by reason of complying with my request to be tattooed.

I fully understand that any employee or agent of this Tattoo Studio when performing a tattoo does not act in the capacity as a medical professional. The suggestions made by any employee or agent of this studio are just suggestions. They are not to be construed as, or substituted for advice from a medical professional.

I UNDERSTAND THAT I WILL BE TATTOOED USING appropriate techniques, instruments and pigments. To ensure proper healing of my tattoo, I agree to follow the written and verbal Tattoo Aftercare instructions that will be provided until healing is complete. I understand that a tattoo may take two weeks or longer to heal properly.

I WILLINGLY SUBMIT TO THESE PROCEEDURES with a full understanding of possible complications such as but not limited to infection, allergic reason or rejection of the ink. Neither the artist nor the Tattoo Studio is responsible 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 THE WRITTEN TATTOO AFTERCARE INSTRUCTIONS which I have read and fully understood 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 confirm I am 18 years of age or older.

I acknowledge that the sterilisation method used was explained to my full satisfaction. I had the opportunity to ask questions regarding this procedure. All questions were answered to my satisfaction. All equipment during the procedure was opened in front of me. I witnessed the disposal of the tattoo needle(s) into regulated sharps containers. Both written and verbal Tattoo Aftercare Instructions were provided to me. I have read this Tattoo Consent & Release Form and confirm that all the information I have given is correct. I understand that this is a release form and I agree to be legally bound by it.

Date
Day
Month
Year

© 2023 by Devoir Tattoo. All rights reserved.

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