Client Consent Form — SANG BLEU LONDON

Pronouns

Email

Phone Number

Address

Next of Kin

To contact in case of emergency

Description of Tattoo

Artist

Guest Artist Name (if applicable)

Tattoo Placement

Tick the box if any of the following apply to you:

Medical advice should be sought in any of doubt as to whether procedure is suitable. If any question answered 'Yes' procedure to be reviewed and medical advice to be obtained.

If answered 'Yes' to any of the questions above please give details and notify the front desk...

Consent to Tattoo Procedure

I acknowledge by signing this agreement that I have been given the full opportunity to ask any and all questions which I might have about the obtaining of a tattoo and that all of my questions have been answered to my full satisfaction. I specifically acknowledge I have been advised of the facts and matters set forth and I agree as follows: If I have any condition, including but not to a blood condition, that might affect the healing of this tattoo, I will advise my tattooer. I am not pregnant or nursing. I am not under the influence of alcohol or drugs. I do not have a medical or skin conditions such as but not limited to acne, scarring (Keloid), eczema, psoriasis, freckles, moles or sunburn in the area to be tattooed that may interfere with said tattoo. If I have any type of infections or rash anywhere on my body, I will advise my tattooer. I acknowledge it is not reasonably possible for the representatives and employees of this tattoo shop to determine whether I might have an allergic reaction to the pigments or processes used in my tattoo, and I acknowledge that such a reaction is possible. I acknowledge that infection is always possible as a result of obtaining of a tattoo, particularly in the event that I do not take proper care of my tattoo. I have received aftercare instructions and I agree to to follow them while 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 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 colour is dark, the colours will not appear as bright as they do on light skin. I understand that tattooing certain areas of the body may be more likely to result in natural reactions such as, but not limited : bleeding ink, keloid scarring or warping which may affect the final appearance of the tattoo. I acknowledge that only I who signs my consent to this procedure is allowed to enter the procedure area. 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 the tattoo. I acknowledge that a tattoo is a permanent change to my appearance and that no representations have been made to me as to the ability to later change or remove my tattoo. To my knowledge, I do not have a physical, mental or medical impairment or disability, which may affect my well being as a direct result of my decision to have a tattoo. I understand that the studio operates as an inclusive, hate-free space and enforces a zero-tolerance policy for discriminatative or abusive speech or behaviour of any kind. I understand that my session will be terminated immediately and I will be asked to leave the tattoo shop if this policy is breached. The studio is monitored by CCTV. I understand images and photos are frequently taken at the studio for social media and/or promotional use. The studio has unrestricted rights to use any image taken within its premises. Any special request is subject to approval by the artist and the studio and if applicable, additional fees. I acknowledge I am over the age of eighteen and that I have truthfully represented to my tattooer that the obtaining of a tattoo is my choice alone. I consent to the application of the tattoo and to any action or conduct of the representative and employees of the tattoo shop reasonably necessary to perform the tattoo procedure.

Signed

Welcome to Sang Bleu Tattoo!