TATTOO Consent Form

Full Name

First NameLast Name

Age

Date of Birth

Date

Phone Number

Area CodePhone Number

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

ID Number

Upload Photo of ID

Browse Files

Are you under the influence of drugs or alcohol?

YesNo

FEMALE ONLY: Pregnancy or Nursing?

YesNo

Do you have a communicable disease?

YesNo

Skin conditions (e.g. Rashes, eczema, infection, psoriasis, freckles, etc.)

If yes, please identify the condition.

Are you currently taking any medication?

Medical History (e.g. DIabetes, Cardiovascular Disease, Epilepsy, Blood-related disease etc.)

If yes, please identify the condition.

Any known allergies ?

Have you previously had semi permanent make up done ? And when if yes also what was it machine or manual

There is always a risk that tattoos can heal patchy and a different color from what has been used. this is out of our control and we cannot guarantee any results or how long they will last do you accept this risk ? *

Top ups may be required we cannot say if you will need extra sessions. Your 6-8 week touch up is required and is included in your first appointment cost. Are you happy to proceed knowing you may need extra sessions to get your desired result from microblading ?

Microblading is a way of cosmetic tattooing, intended to be semipermanent lasting average 12-18 months. On a rare occasion, the pigment may migrate under the skin. Please understand this is a risk which can happen although Rare . Do you accept this risk *

Please check bellow to confirm you have read and fully understand the following*

I understand that this procedure is a permanent change to my skin and body.

I allow my tattoo to be photographed and be used for Hope Esthetics/ Ashley Knight portfolio showcased.

I acknowledge that Hope Esthetics/ Ashley Knight does not offer refunds.

I agree that the studio does not have a way of identifying if I am allergic to the elements or ingredients that will be used for my tattoo.

Sometimes bleeding cannot be made undercontrol and you will still be charged for your session . Caffeine and alcohol for 48hr prior is an absolute NO ! As this will effect bleeding

If you bleed a lot during treatment this can have an effect on healing this is something we cannot control

I understand that I need to take care of the tattoo/pmu by following the instructions given to me by Hope/ Ashley

NO GYM / WORKING OUT FOR 7 days ? You agree not to exerciseAftercare is vital and it is YOUR Responsibility to look after your brows to achieve the best healing

PMU*

most customers need a touch up to assure that the pmu is perfectly even and desired effect was achieved. Some people may need several sessions to perfect the perfect brows each extra session will be extra charge.

I understand that I might get an infection if I don't follow the instructions given to me in regards of taking good care of my tattoo.

I indemnify and hold harmless Hope Esthetics, Hope Roaden and Ashley Knight against any claims, expenses, damages, and liabilities.

I confirm that the information I provided in this document is accurate and true.

Signed Date

Date

Client Signature

TATTOO Consent Form

Client Information

Pre-Procedure Questionnaire

Acknowledgment and Waiver