Consent Form – Drea Darling Tattoo

YOUR DETAILS

First name *

Last name *

Email Address *

Phone Number *

Date of Birth dd/mm/yyyy *

Join our mailing list?

Yes

Address

Suburb

Emergency Contact name *

Relationship to you

Emergency Contact Ph: *

How did you find out about Drea Darling? * How did you find out about Drea Darling?

PLEASE ANSWER THE FOLLOWING QUESTIONS

Have you ever received a professional tattoo before? *

Yes

No

Have you eaten in the last 4 hours? *

Yes

No

Have you consumed any alcoholic beverages in the last 24 hours? *

Yes

No

Have you taken any aspirin, ibuprofen, or blood thinners in the last 24 hours? *

Yes

No

Are you prone to fainting? *

Yes

No

Are you prone to heavy bleeding? *

Yes

No

Have you have ever had an allergic reaction to any of the following?

Do you have any other allergies? If yes, please specify. *

YesYes

No

Are you pregnant or breastfeeding? *

Yes

No

Do you have any communicable diseases? (H.I.V., A.I.D.S., HEPITITIS) *

Yes

No

Do you have any other conditions which might affect the healing of this tattoo? *

YesYes

No

TATTOO CONSENT & RELEASE

Please check the boxes to indicate that you have read, understood and agreed to each section.

To induce DREA DARLING to tattoo me and in consideration of its doing so, I hereby release the tattoo studio, the tattoo artist and any employees and associates thereof from all manner of liabilities, claims, actions and demands, in law or in equity, which I or my heirs have or might have now or hereafter by reason of complying with my request to have a tattoo procedure performed.

I understand that any employee or agent of this studio when performing a tattoo does not act in the capacity of a medical professional. The suggestions made by any employee or agent of the studio are not to be construed or substituted for advice from a medical professional.

I understand I will be tattooed using appropriate instruments and techniques. To ensure proper healing of my tattoo, I agree to follow the aftercare instructions outlined in the written tattoo aftercare instructions provided to me until healing is complete. (Please see www.dreadarling.com/aftercare)

I assume full responsibility for aftercare and cleanliness as I have read and fully understand the aftercare instructions. I agree that any touch-up work needed, due to my own negligence, will be done at my own expense. This includes any tattoos on fingers/ hands/ palms/ feet & ears, as I have been duly informed that these areas are physiologically predisposed to the dropping out, fading and/or blurring of ink.

I willingly submit to these procedures with a full understanding of possible complications such as, but not limited to infection, allergic reaction, or rejection of the ink. Neither the artist nor the studio is responsible for the meaning/ spelling of the symbol or lettering that I have provided them or have chosen from flash design sheets.

I understand that by having this tattoo performed I am making permanent change to my body and no claims have been made regarding the ability to undo changes made.

Identification & Signature

Signature *

Clear

Please attatch a photo of your government issued ID *

Maximum file size: 134.22MB