TATTOO CONSENT & RELEASE FORM

REBEL INKS TATTOOS, TATTOO REMOVAL, AND BODY PIERCINGS PARLOUR

1. CLIENT INFORMATION

Full Name *

Email *

Phone Number *

Emergency Contact (Name & Phone) *

ID/Passport No. *

2. TATTOO DETAILS

Tattoo Description/Design *

Tattoo Location on Body *

Approximate Size

Ink Type *

Coloured Black & Grey

3. MEDICAL & HEALTH QUESTIONNAIRE

Please check YES or NO to the following questions:

Are you under the influence of alcohol or drugs today? *

Yes No

Are you pregnant or breastfeeding? *

Yes No

Do you have any skin conditions (e.g., eczema, psoriasis, rashes) near the tattoo area? *

Yes No

Do you have diabetes, heart conditions, or blood disorders? *

Yes No

Do you take any blood thinners or medications that affect healing? *

Yes No

Are you allergic to latex, metals, pigments, or any tattooing materials? *

Yes No

Have you eaten in the last 4 hours? *

Yes No

Do you have any communicable diseases (e.g., Hepatitis, HIV, COVID-19)? *

Yes No

If you answered “YES” to any question above, please explain: *

4. CLIENT ACKNOWLEDGEMENT

Please read carefully and initial each point: *

I understand that getting a tattoo is a permanent procedure and that removal may be difficult, costly, or impossible. I acknowledge that tattoos may cause some pain, bleeding, swelling, and discomfort during and after the procedure. I understand that there are potential risks, including infection, allergic reaction, scarring, keloids, or pigment loss. I have disclosed all known medical conditions and allergies to the tattoo artist. I confirm that I am not under the influence of drugs or alcohol and am mentally competent to give consent. I understand that proper aftercare is my responsibility and that failure to follow instructions may result in infection or poor healing. I understand that no refunds will be issued once the tattooing process begins.

5. STUDIO & ARTIST DISCLAIMER

- All equipment used is sterilized and single-use for each client. - The tattoo artist will maintain professional hygiene standards throughout the procedure. - The client is responsible for ensuring they are medically and mentally fit for tattooing. - The studio and its staff are not liable for complications arising from the client’s failure to disclose relevant medical information or to follow aftercare instructions.

6. AFTERCARE CONFIRMATION *

I have received and understood the tattoo aftercare instructions provided by the artist, including guidance on cleaning, moisturizing, and avoiding exposure to sun, water, and contamination during healing.

7. CONSENT & RELEASE *

I hereby release and hold harmless the tattoo artist and the studio from any and all claims, damages, or legal actions arising from the tattoo procedure. I certify that I am at least 18 years of age, have provided valid identification, and am signing this form voluntarily.

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Name *

Email *

Phone No. *

Sex *

Male Female

Please Select Your Service *

What would you like to get done *

Disclaimer: This is not a confirmed schedule, details provided will aid our specialists in planning a convenient time schedule that favours both parties when they get in touch with you for clarification.

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