Tattoo Consent & Release Form

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I am not pregnant or breastfeeding*

I do not suffer from hemophilia. I do not suffer from any heart conditions or take medications that thin the blood.*

I do not suffer from Hepatitis or any other communicable disease. I have informed the tattoo artist and have been advised of any medications or procedures necessary to promote satisfactory healing of my tattoo.*

I have advised the tattoo artist of any allergies to metals, latex, soap or medications. I acknowledge it is not possible for the tattoo artist to determine whether I might have an allergic reaction to the tattoo or the process involved in the tattooing and further acknowledge that such a reaction is possible.*

I have truthfully represented to the tattoo artist that I am over 18 years of age. I am not under the influence of any drugs or alcohol. To my knowledge, I do not have any physical, mental or medical impairment or disability which may affect my judgement and/ or my wellbeing as a direct or indirect result of my decision to have a tattoo done at this time.*

I acknowledge that obtaining a a tattoo is my choice and will result in a permanent change to my appearance, and that no representation has been made to me as to the ability to later restore my skin to a pre-tattooing condition.*

I acknowledge infection is always possible as a result of obtaining a tattoo and I agree to follow all instructions concerning the care of my tattoo while it is healing.*

I realize that variations in colour and design may exist between any tattoo as selected by me and as ultimately applied to my body. I understand that if my skin is dark, the pigments will not appear as bright as they do on lighter skin. I understand that a tattoo is a handmade work of art and minor imperfections are likely.*

I do not suffer from skin conditions such as but not limited to keloid or hypertrophy scarring, psoriasis at the site of the tattoo or any open lesions at the site of the tattoo.*

I authorize the tattoo artist to move forward with the procedure. I understand this type of procedure usually takes 2 weeks or longer to heal. I agree to release and forever discharge and hold harmless the tattoo artist and all employees from any and all claims, damages or legal actions arising from or connected in any way with my tattoo, or the procedure and conduct used in my tattooing. Dominic Kirouac, Modern Markings Tattoo and Sundog Studios are not liable.*