Consent Form – TATTOO Please enable JavaScript in your browser to complete this form. - Step 1 of 3DateTimeDescription *Size *ARTIST *Deposit *Total *Next THIS FORM CONFIRMS YOUR CONSENT TO BE TATTOOED IN OUR PREMISES. ALL THE DETAILS ABOUT YOUR HEALTH ARE PROTECTED BY DATA PROTECTION ACT 1998. YOUT MUST BE 18 OR OLDER TO BE TATTOOED. Are you 18 or older ? *YesNoAge * CUSTOMER DETAILS Name *Surname *Date of birth *ID numberEmail *Phone *Address *Address Line 1CityPostal CodeAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAscension IslandAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCanary IslandsCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicCeuta and MelillaChadChileChinaChristmas IslandClipperton IslandCocos (Keeling) IslandsColombiaComorosCongo (DRC)Congo (Republic)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d’IvoireDenmark (Danmark)Diego GarciaDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard & McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedonia (FYROM)MadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia & South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSt. Vincent & GrenadinesSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaSão Tomé and PríncipeTaiwan, Province of ChinaTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluU.S. Outlying IslandsU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabwe PARENT DETAILS Parent's Name *Parent's Surname *Parent's Date of birth *Parent's Email *Parent's Phone * CUSTOMER HEALTH DETAILS PLEASE MAKE A CHECK MARK IF YOU ARE SUFFERING FROM/HAVE SUFFERED FROM THE FOLLOWING CONDITIONS: Any heart condition:High blood pressureLow blood pressureLow blood sugarProne to faintingHiv infectionAcneSeizures (e.g. epilepsy)Hepatitis A, B or CKeloids skinDiabetsEczemaHaemorrhageAllergies to: anesthetics, adhesive plaster, jewellery or latex? *YesNoAre you pregnant or breastfeeding? *YesNoAre you taking any blood or medication as Warfarin, Aspirin etc? *YesNoPlease list any current medications/treatments from the hospitalHow did you hear about us?FacebookGoogle searchWalking by the studioOtherHow did you hear about us? :: other Next TERMS I AM NOT UNDER THE INFLUENCE OF DRUGS OR ALCOHOL. I AM 18 OR OLDER AND I UNDERSTAND THE CONTENTS OF THIS FORM FULLY. THE MEDICAL HISTORY I HAVE PROVIDED IS CORRECT TO THE BEST OF MY KNOWLEDGE AND I UNDERSTAND THAT BY NOT DECLARING EVERYTHING CAN PREJUDICE MY TATTOO. I UNDERSTAND TATTOOING IS AN ART FORM AND THERE IS NOT 100% GUARANTEE ON THE COMPLETE ACCURACY OF THE PICTURE. IF I AM GETTING A TEXT TATTOO IT HAS BEEN MY RESPONSIBILITY TO CHECK THE SPELLING ACCURACY OR THE TRANSLATION BEFORE BEING TATTOOED. I UNDERSTAND THAT FAIL TO FOLLOW THE TATTOO AFTERCARE INSTRUCTIONS CAN RESULT IN INFECTIONS AND IS NOT THE RESPONSIBILITY OF THE TATTOO STUDIO OR THE TATTOOIST ONCE I LEAVE THE STUDIO. ASSOCIATED RISKS INCLUDE: BLOOD POISONING (SEPTICAMIA). TERMS AND CONDITIONS AN HOURLY RATE IS CHARGED FOR THE TIME TAKEN TO WORK ON YOUR TATTOO. DISCOUNTS ARE AVAILABLE FOR SMALL, MEDIUM AND LARGE TATTOOS. THEY WILL BE APPLIED ON YOUR NEXT ONE IF YOU LEAVE A POSITIVE REVIEW. TO BOOK AN APPOINTMENT, YOU WILL BE REQUIRED TO PAY A DEPOSIT OF £50. FOR MULTI-SESSION TATTOOS, THE DEPOSIT WILL BE HELD AS PAYMENT TORWARDS THE LAST SESSION OF THE TATTOO. THE PAYMENT CAN BE MADE AT THE SHOP OR IN SOME CASES ONLINE, VIA PAYPAL OR BANK TRANSFER. CASH AND CARD PAYMENT ARE BOTH ACCEPTED. THE DEPOSIT IS NON-REFUNDABLE IN THE EVENT THAT: THE CLIENT FAILS TO ATTEND THEIR APPOINTMENT OR CANCELS IT; THE CLIENT CANCELS OR RECHEDULES AN APPOINTMENT WITHOUT GIVING AT LEAST ONE WEEK NOTICE; THE CLIENT ARRIVES MORE THAN 30 MINUTES LATE TO A TATTOO APPOINTMENT; THE CLIENT RESCHEDULES 3 TIMES FOR ANY SESSION OF THE SAME TATTOO, REGARDLESS OF NOTICE; THE CLIENT ARRIVES TO A TATTOO APPOINTMENT WITHOUT A PROOF OF IDENTIFICATION. Customer signature *Clear SignatureGDPR Agreement *I consent to having this website store my submitted information so they can respond to my inquiry. Almost Done.Here you can review the form content before hitting SUBMIT at the end of the page.Updating preview…PreviousSubmit
