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?

FEMALE ONLY: Pregnancy or Nursing?

Do you have a communicable disease?

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

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

PMU

Signed Date

Date

Client Signature

TATTOO Consent Form

Client Information

Pre-Procedure Questionnaire

Acknowledgment and Waiver