CONSENT FORM

I acknowledge by signing this agreement that I have been given the full opportunity to ask any and all questions I might have about obtaining a tattoo, and that all of my questions have been answered to my full satisfaction. I specifically acknowledge that I have been advised of the facts and matters set forth below, and I agree as follows:

If I have diabetes, epilepsy, hepatitis, hemophilia, HIV/AIDS, or any other communicable disease, heart condition, or if I take medication that thins my blood, I have advised my tattoo artist. I am not pregnant or nursing. I am not under the influence of alcohol or drugs.

I do not have any medical or skin conditions such as, but not limited to, acne, scarring (keloids), eczema, psoriasis, freckles, moles, or sunburn in the area to be tattooed that may interfere with the tattoo process.

I acknowledge that it is not reasonably possible for the representatives or employees of this tattoo shop to determine whether I might have an allergic reaction to the pigments or processes used in my tattoo, and I agree to accept the risk that such a reaction is possible.

I understand that infection is always possible as a result of obtaining a tattoo, particularly if I do not take proper care of my tattoo. I have received aftercare instructions and agree to follow them while my tattoo is healing. I agree that any touch-up work needed due to my own negligence will be done at my own expense.

I realize that variations in color and design may exist between the tattoo I select and the final result on my skin. I understand that if my skin tone is dark, the colors may not appear as bright as they do on lighter skin. I also understand that any future skin treatments, laser hair removal, plastic surgery, or other skin-altering procedures may result in adverse changes to my tattoo.

I acknowledge that a tattoo is a permanent change to my appearance, and no representations have been made to me regarding the ability to later change or remove my tattoo. To my knowledge, I do not have any physical, mental, or medical condition that might affect my well-being as a direct or indirect result of receiving a tattoo.

I acknowledge that I am over the age of eighteen (18) and that I have truthfully represented to my tattoo artist that the decision to obtain a tattoo is my choice alone. I consent to the application of the tattoo and to any actions or conduct by the representatives or employees of the tattoo shop reasonably necessary to perform the tattoo procedure.

I fully understand that THE TATTOO ARTIST DOES NOT ACT AS A MEDICAL PROFESSIONAL. Any suggestions or advice given to me are not to be construed as, or substituted for, medical advice.