Stigma Ink Minor Tattoo Consent

First name

Last name

Email

Address

Phone

Birthday

Yes, subscribe me to your newsletter.

Are you in the Armed Services?

If so, what was/is the branch & rank of Service?

Location on the Body the Tattoo Procedure is being performed?

I acknowledge by signing this release I have been given the full opportunity to ask any and all questions which I might have about obtaining a tattoo from Stigma Ink and all my questions have been answered to my full and total satisfaction. I acknowledge I have been advised of the matters set forth below and I agree to the following:

I am not pregnant or nursing. If I have any condition that might affect the healing of this tattoo. I will inform my artist.

I do not suffer from medical or skin conditions such as, but not limited to: acne, keloid or hypertrophic scarring, psoriasis, freckles, moles or sunburn in the area to be tattooed that may interfere with said tattoo. If I have any type of infection or rash ANYWHERE on my body, I will advise my artist.

I am not under the influence of drugs or alcohol.

I acknowledge it is not reasonably possible for the representatives, owner or contractors of this tattoo shop to determine whether I might have an allergic reaction to the pigments or processes used in my tattoo, and I agree to accept the risk that such a reaction is possible.

I will inform my artist if I am on ANY MEDICATION for any medical reason or otherwise. Blood thinners, hormones or antibiotics will be disclosed to my artist and we retain the right to adjust tattoo viability based on this information.

I realize that variations in color and design may exist between any tattoo as selected by me and as ultimately applied to my body. I understand that color brightness and vibrance varies according to skin tone.

I understand that if I have had any skin treatments, laser hair removal, plastic surgery, or any other skin altering procedures, it may result in adverse changes to my tattoo.

I acknowledge that a tattoo is a permanent skin alteration and 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 any physical, mental or medical impairment or disability which might affect my well-being as a direct or indirect result of my decision to have tattoo/s done at this time.

I acknowledge I am over the age of 18 and that I have truthfully represented to my artist that the tattoo procedure is by my choice alone. I consent to the application of that tattoo and to any reasonable actions or conduct of my artists and shop representatives to complete my procedure/s.

I give my artist/Stigma Ink permission to use pictures/video of my tattoo at their disgresssion in both print and online venues.

I agree to immediate contact and mediation with the owner of Stigma Ink/artist if any concerns arise during or after procedure/s performed. Mediation matters will be promptly handled by Stigma counsel.

I understand inner lip, fingers, hands and feet tattoos are not guaranteed. All touchups recieve one free touchup, but are not guaranteed past touchups on said areas of body.

Date

Minor & Guardian Upload ID

Minor Signature

Birth Certificate Upload

Guardian Signature

Artist