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Home
Gallery
Workshops
Nature Art
Water colour
Oil Painting
Children Sessions
Tattoo Studio
Contact
Tattoo Consent and Release Form
Client Details
ID Verification
ID Type
Driver Licence
Passport
Proof of Age Card
Other
ID sighted by the artist?
Yes
No
Medical Questionnaire
Please answer the following questions: Answering ‘yes’ to any of these questions does not necessarily preclude the person from receiving a tattoo.
Has a physician told you that you have hepatitis?
Yes
No
Are you prone to fainting?
Yes
No
Do you have diabetes?
Yes
No
Do you have difficulty stopping bleeding?
Yes
No
Do you take blood thinners?
Yes
No
Do you have heart-related problems?
Yes
No
Do you have high blood pressure?
Yes
No
Do you have known allergies?
Yes
No
Have you consumed alcohol in the last 8 hours?
Yes
No
Have you consumed food in the last 2 hours?
Yes
No
Have you consumed anticoagulants in the last 24 hours?
Yes
No
Are you pregnant or breastfeeding?
Yes
No
Do you have any other conditions that may affect healing?
Yes
No
Consent & Acknowledgement
I herby give consent to the artist to perform a tattoo, and in consideration of doing so, I hereby release the artist and Newtown Art Studio from all manner of liabilities, claims, actions, and demands in law, or in equity, which I or my heirs might now or hereafter by reason of with my request to be tattooed.
I fully understand that any employee of Newtown Art Studio, when performing a tattoo, does not act in the capacity as a medical professional. The suggestions made by any employee or agent of Newtown Art Studio are just suggestions. They are not to be construed as, or substituted for advice from a medical professional. I understand that a tattoo will be performed using appropriate techniques, instruments, and pigments. I also understand that infections can occur due to lack of proper hygiene and/or pigment sensitivities. To ensure proper healing of my tattoo, I agree to follow the written and verbal aftercare instructions that have been provided, until healing is complete. I understand that a tattoo may take several weeks to heal properly, and I agree to follow the aftercare suggestions outlined. I have received a copy of the written tattoo aftercare instructions, which I have read and fully understand and hereby assume full responsibility for aftercare and cleanliness. I am aware and accept that the tattoo will fade over time and that the ink could blur out.
I willingly submit to these procedures, with a full understanding of possible complications such as, but not limited to, infection and allergic reaction or rejection of the ink. Neither the artist nor the studio is responsible for the meaning or spelling of symbols or script, or checking copyright implications. I am aware I am expected to check the copyright of all designs prior to moving forward. I understand that I am making a permanent change to my body, and no claims about the possibility of reserving these changes have been made or implied by Newtown Art Studio or any of its employees or agents.
Signature
Please pass to the artist to review and submit
Do not press- please pass to the Artist
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