CLIENT CONSENT FORM

First Name

Last Name

Phone

Address

Date of Birth

Drivers Licence No.

Appointment Date

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 being tattooed

I acknowledge that I am not pregnant.

I acknowledge that I am free communicable diseases, E.g. HIV, Hepatitis, Staph infection etc

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, and I have been advised of the signs and symptoms of infection that indict a need to seek medical care.

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

I acknowledge that the obtaining of my tattoo is my choice alone and I consent to The Laughing Buddha Tattoo to perform the tattoo procedure. I agree that I will not lodge legal actions and/or any claims arising in any way with my tattoo or the procedures used by my tattooist .

The Laughing Buddha Tattoo have fully informed me of the risks of tattooing including but not limited to infection, scarring, any allergic reactions to tattoo pigment, latex gloves, and/or any other products used for the act of tattooing. I still wish to proceed with my tattoo and I assume any and all risks that may arise from tattooing.

Signature

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