Consent Form

Please fill out every section and carefully read through the declaration at the bottom. No tattooing will commence until we receive confirmation that the form has been filled out. If you look under 25 years old, we will require to see government approved photo ID which we will scan in and keep on record.

If you're unsure, please ask
Please choose from the list.
Client Name *
Client Name
Date of birth *
Date of birth
If you're under 25 years old, please have ID ready
Address *
Medical History
Do you currently have, or have you ever had any any of the following medical conditions?
Blood Borne Disease (HIV, Hepatitis, etc) *
Heart Conditions *
Epilepsy / Seizures *
Haemophilia / Blood Clotting Disorders *
Diabetes *
Lung Disorders / Severe Asthma *
Allergic Response (Anaesthetics, Latex, etc) *
Skin Complaints (Eczema, Psoriasis, etc) *
Fainting Attacks / Dizziness *
Do you take regular medication? *
Do you take blood thinning medication? *
Could you be pregnant? *
Please read carefully
I declare that the above information is true and correct to the best of my knowledge. I am over 18 years old and able to give full consent for the procedure detailed above. I am not under the influence of drugs or alcohol. I hereby give consent for the artist named above to carry out the tattoo procedure and have approved the design to be used. I understand the potential risks and complications that are associated with the procedure and confirm that I have been given access to the appropriate aftercare advice. I understand that it is my responsibility to carry out the instructions as suggested by the operator to assist the best possible healing conditions for my tattoo. I give consent for the information on this form to be held by the operator and studio for a minimum of two years from the date of the procedure.
Promotional Tattoo Photography *
Do you consent to photographic images to be taken and used for advertising or portfolio purposes on social media/print media by both the studio and the artist? This may extend to other third parties given approval by the studio or the artist