@SHAYTATTOOS
401.490.1910
tattooedbyshay@gmail.com
1527 Main Street, West Warwick RI

tattoo appointment CONSENT FORM

with Shay (Tattoo Artist)

Please fill out the following form before your appointment.

First LEGAL Name

Last LEGAL Name

Email

Phone number

Date of Birth

Age

Address

City

State

i acknoweldge by signing this agreement that i have been given the full opportunityto ask any and all questions i may have about the tattoo procedure and aftercare. all answers have been given to my full satisfaction. i specifically acknowledge i have been advisedof the facts and matters set forth below and agree as follows:

if i have diabetes, hepatitis, hemophilia,HIV/AIDS and/or any communicable disease, heart condition, medications, or other concerns- i have advised by tattoo artist before hand. I am not pregnant or nursing. i am not under the influence of drugs or alcohol.

i do not have medical skin conditions such as but not limited to: acne, scarring, keloids, eczema/psoriasis, freckles, moles, sunburn etc. in the area to be tattooed that may interfere

i acknowledge that it is not reasonably possible for the representatives and employeesof this tattoo establishment to determine whether i might have an allergic reaction to pigments etc. used in my tattoo(s). i agree to accept the risk that such reaction is possible.

i acknowledge that infection is always possibleas a result of obtaining a tattoo, particularly in result of not properly caring for my tattoo as instructed by my tattoo artist. i have recieved aftercare instructions and agree to follow them as 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 any tattoo selected by me and ultimately applies to my body. i understand that my skin tone will affect how dark/bright colors will appear.

i understand that if i have any skin treatments, laser hair removal, plastic surgery or other skin altering procedures it may result in adverse changes to my tattoo.

i acknowlege that a tattoo is a permanent change to my appearence and that no representations have been made toward me regarding the ability to later change or remove my tattoo. To my knowledge i do not have any physical, mental or medical impairment or disability which may affect my well being as as a direct or indirect result of my decision to get a tattoo.

i acknowledge that i am over the age of 18 and that i have truthfully represented to my tattoo artist that the obtaining of my tattoo procedure is done by my choice alone. i consent to the application of my tattoo and to any actions or conduct of the representatives and employees of the tattoo studio reasonably neccessary to preform for the tattoo procedure.

i fully understand that the tattoo artist does not act as a medical professional. any suggestions made to me are NOT to be constituted as or substituted for advice of a medical professional.

tattoo description

appointment date and time

todays date

Your Signature

upload a copy of your ID

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I declare that the info I’ve provided is accurate & COMPLETE

Thanks for submitting!

Tattooer / Artist

Tattooedbyshay@gmail.com

401.490.1910 CALL OR TEXT

www.shaytattoos.com

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