CONSENT FORM

TATTOO CONSENT FORM - MINOR

4506 Lorain Ave, Cleveland, Ohio, 44102

I understand and agree to the following:

• I do not suffer from any of the following: Diabetes / Hemophilia / Skin Disease / Skin Lesions /Allergies or Sensitivity to: to pigments, dyes, disinfectants, metals, Latex or Soap.

• I do not have a history of any of the following medical conditions: Epilepsy / Seizures / Fainting / Narcolepsy / Communicable Disease (ie: Hepatitis A, B, and C, HIV/AIDS, Influenza, Sexually Transmitted Infections.)

• I do not take any of the following medications: Anticoagulants / Medications that would interfere with blood coagulation/thin the blood. I have informed my artist and front desk staff if I am immune or neurologically compromised.

• Risks involved with tattoos which include but are not limited to: Rash / Disease / Infection / Allergies / Sunburn / Pimples / Boils.

• I am obligated to tell the body artist of any information that would aid the artist during my tattoo and while healing, including suffering from any medical conditions listed above. Continuing to get a tattoo with any medical condition is at my own risk. I am not pregnant or nursing.

• That tattooing is permanent and can only be removed using surgery or a laser procedure that may result in scarring.

• I will receive after care instructions explaining additional information on expectations, and how to care for my tattoo.

• To follow instructions concerning the care of my tattoo while it is healing.

• Touch up work needed due to my own negligence, will be done at my own expense.

• That if my skin is dark, the colors may not appear as bright as they would be on lighter skin.

• Tattoo procedures must be paid in full at the time of service.

• Please consult a physician at the first sign of an adverse reaction(i.e.,swelling,infection, illness, allergic reaction or disease.

I agree for myself, my heirs, assigns, and legal representatives to hold Artist representing STUDIO 3 TATTOO harmless from all damages, actions, causes of actions, claim judgments, cost of litigations, attorney’s fees, and all other costs and expenses which might arise from my decision to have any tattoo related work at STUDIO 3 TATTOO. I agree to pay for any and all damages and injuries to any and all persons and property belonging to STUDIO 3 TATTOO or any other persons to whom STUDIO 3 TATTOO may become liable contractually or by operation of law, caused by or resulting from my decision to have any tattoo related work by artists representing STUDIO 3 TATTOO. I agree to leave the premises of STUDIO 3 TATTOO or any other establishment where STUDIO 3 TATTOO is engaged in business, promptly upon request, for any reason whatsoever, by any agent or employee of STUDIO 3 TATTOO.

Being of sound body and mind, I hereby release any and all persons representing STUDIO 3 TATTOO from all responsibility. I have been given both written and verbal instructions regarding risks, outcome, and aftercare of the potential risks associated with getting a tattoo. I still wish to proceed with the tattoo and I freely accept and expressly assume any and all risks that may arise from being tattooed. 

I accept any and all responsibility for myself and for any consequences that might stem from my decision to have any tattoo work done by an Artist representing STUDIO 3 TATTOO.

BY SIGNING BELOW I AGREE THAT I HAVE READ THIS AGREEMENT, I UNDERSTAND IT, I AGREE TO BE BOUND BY IT. By signing below, I represent and warrant that the following information is true and I/we release all claims that they and/or I have:

Staff Portion (PLEASE HAND BACK TO STAFF)