Consent | Inkd Fine Line Tattoo

Consent Form

First name

Last name

Email

Address

Birthday

Month

Day

Year

Phone

I acknowledge by signing this release form that I have been given the full opportunity to ask any and all questions I might have about obtaining a tattoo from JaQuoi. I acknowledge that all my questions have been answered to my full and total satisfaction. I specifically acknowledge that I have been advised of the facts and matters set forth below, and I agree as follo

I am not under the influence of alcohol or drugs.

I do not have acne, freckles, moles, or sunburn in the area to be tattooed that might be agitated by the tattoo process (healing excluded).

I have looked over my design, checked the spelling if applicable, and give my full consent to the application of my tattoo.

I acknowledge that I am not pregnant.

I acknowledge that I am free of communicable diseases.

I acknowledge that I have truthfully represented to the associates, agents and representatives of JaQuoi that I am over eighteen years of age.

I acknowledge it is not reasonably possible for the associates, agents, and representatives of JaQuoi to determine whether I might have an allergic reaction to the dyes, pigments, or processes used in my tattoo and I agree to accept that such risks are possible.

I acknowledge that infection is always possible as a result of obtaining a tattoo, particularly in the event that I do not take proper care of my tattoo or permanent cosmetic tattoo, and I have been advised of the signs and symptoms of infection that indicate a need to seek medical care.

I acknowledge receipt of written instructions advising me of proper care of my tattoo/permanent cosmetics and recognize the absolute necessity of following those written instructions. All questions about the procedure have been answered to my satisfaction.

I acknowledge that variations in color and design may exist between any tattoos as selected by me and as ultimately applied to my body.

I acknowledge that tattooing/permanent cosmetics is a permanent change to my appearance and that no representations have been made to me as to the ability to later change, alter or remove my tattoo.

I acknowledge that the obtaining of my tattoo/permanent cosmetics is my choice alone and I consent to the application of the tattoo and to any actions or conduct of the associates, agents or representatives of JaQuoi that are reasonably necessary to perform the tattoo procedure.

I agree to release and forever discharge and forever hold harmless JaQuoi and its associates, agents, officers and shareholders from any and all claims, damages, or legal actions arising from or connected in any way with my tattoo or the procedures and conduct used to apply my tattoo and any and all tattoos applied by JaQuoi and its associates, agents and representatives in the future.

I acknowledge that there is a chance I might feel lightheaded, dizzy during or after being tattooed. I agree to immediately notify the artist in the event I feel any of that mentioned above before, during or after the procedure. I agree to follow all instructions concerning the care of my tattoo or permanent cosmetics procedure, and that any touch-up needed after those allowed, will be done at my own expense.

I have been fully informed of the risks of tattooing including but not limited to infection, scarring, difficulties in detecting melanoma, and allergic reactions to the ink. Having been informed of the potential risks associated with getting a tattoo, I still wish to proceed with tattoo application and I assume any and all risks from tattooing.

I do give JaQuoi and her associates permission to use my image for educational and advertising purposes.

Signature

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