Tattoo Consent Form — Prick's Tattoo

Client Information

First Name *

Last Name *

Date of Birth *

Phone *

Email

Address

Emergency Contact Name

Emergency Contact Phone

Artist

Tattoo Placement

Tattoo Description

Government-Issued Photo ID(optional — attach a photo or scan)Click to upload ID photo

Health & Medical History

Answer yes or no to each question. * required

Additional notes or conditions

Acknowledgment & Consent

Are you 18 years of age or older? *

yesno

I understand that tattooing is a permanent body modification and I am proceeding of my own free will.I acknowledge that all tattoo equipment used will be sterile and single-use needles will be used.I understand there is a risk of infection if aftercare instructions are not followed properly.I release Prick's Tattoo and its artists from liability for any complications arising from failure to disclose medical conditions or follow aftercare instructions.I consent to photographs of my tattoo being used for portfolio and promotional purposes (optional).(optional)

Signature (type full name) *

Date

This form is for informational and record-keeping purposes. It does not constitute a medical document.