tattoo consent form

Name *

First Name

Last Name

Email *

Phone *

(###)

###

####

Date of birth

MM

DD

YYYY

Tattoo quote *

£

Health conditions *

heart conditions

epilepsy

viruses

diabetes

psoriasis

eczema

keloid scars

pregnancy

breastfeeding

prone to fainting attacks

none

Allergies

Let us know what allergies do you have. If not, put N/A.

I have eaten in the last 2 hours *

I have not consumed alcohol or drugs in the last 24 hours *

Thank you!