Consent & Release Form

Full Name *

Date *

Phone *

Tattooer *

THE TATTOO ARTIST AGREES TO USE STERILE AND DISPOSABLE MATERIAL. ONLY THEY ACKNOWLEDGE BEING IN FULL POSSESSION OF THEIR MEANS AND AGREE TO EXECUTE THE TATTOO MOST FAITHFULLY TO THE STENCIL. ANY MODIFICATION OF THE ORIGINAL PROJECT WILL BE VERIFIED UPON BEGINNING THE SESSION WITH THE CLIENT AND THE TATTOO ARTIST.

Are you older than 18? *

YES/OUI

NO/NON

Are you pregnant or breastfeeding? *

YES/OUI

NO/NON

Do you have hemophilia or another blood disease? *

YES/OUI

NO/NON

Did you take alcohol or drugs in the last 24H? *

YES/OUI

NO/NON

Do you have any allergies? (Latex, Vaseline, Band-Aid, etc.) *

YES/OUI

NO/NON

Will you acknowledge post-tattoo care? *

YES/OUI

NO/NON

Do you take medication that liquifies blood? *

YES/OUI

NO/NON

I discharge the tattoo artist of any consequences due to getting tatooed (Infection, allergies, etc.) and I assume the entire responsibility *

AGREE/ACCEPTE

DISAGREE/REFUSE

I acknowledge recognizing the risks tattooing involved, even when done exceptionally *

YES/OUI

NO/NON

I agree to follow the tattoo artist's recommendations to ensure the best healing possible *

YES/OUI

NO/NON

I acknowledge that this tattoo is my choice, is permanent and that it will result in a permanent change to my appearance *

YES/OUI

NO/NON

I acknowledge not having any condition that could alter my judgement into getting tattooed. *

YES/OUI

NO/NON

By signing this document, I acknowledge everything stated above. *

I hereby accept and give my clear and free consent for the collection, communication and use of my personal information by Oly Anger Tattoo, whether my personal information is collected by Oly Anger Tattoo or Funnel Vision Systems, for the purposes of obtaining tattoo services.

Updates

I agree to text message & email updates regarding my request with Oly Anger Tattoo.

How did you hear about us? *