Tattoo Release Form -

I certify that the above information is true and correct to the best of my knowledge. I enter in this agreement on my free will and I am in a sober (drug and alcohol free) condition. I certify that I am at least 18 years of age. To induce the above named artist to tattoo/pierce my body and in consideration of their doing so, I hereby release the above named artist from all liability, claims, damages, lawsuits, and demands, in law or equity, to the extent allowed by law, which I or my heirs might have now or hereafter, arising from or for complying with my request to be tattooed. I understand that any tattoo should be considered permanent; that it can only be removed with a surgical procedure; and that any effective removal may leave scarring. Body piercing may leave scarring. I understand that I will be tattooed using appropriate techniques to ensure proper healing of my tattoos. I agree to follow the procedures outlined on the accompanying care form for the care of tattoo until healing is complete. I understand that this type of tattoo takes 2 or more weeks to heal. I further understand that even with appropriate techniques, instruments, and the utmost of care, infection is always possible, and assume the risk of such infection regardless of its cause. I further understand that there is always the possibility of an allergic reaction to some of the tattooing pigments and assume the risk of such allergic reactions. I acknowledge that I am not suffering from or history of: diabetes, allergies, AIDS, hemophilia, immune disorders, epilepsy, seizures, fainting, narcolepsy, allergies or adverse reactions to pigments, dyes or other skin sensitivities, discoloration, swelling, lumps, scarring (keloid), skin diseases, skin lesions or skin sensitivities to soap, disinfectants, etc. or other types of irritation of the area to be tattooed, pregnancy or breast-feeding/nursing or any other condition that would make this condition dangerous. Any condition that requires the client to take medications such as anticoagulants that thin the blood or interfere with blood clotting, or any other information that would aid the technician in the body art procedure. Also last time you ate. The above named artist makes no warranties as to the meaning of any tattooed symbols or designs. The above named artist is not responsible for any complications due to mistreatment of the tattoo. The technician shall not perform a body art procedure if the client fails to complete or sign the disclosure and authorization form, and the technician may decline to perform a body art procedure if the client has any identified health conditions.Contact a qualified health care professional at the first sign of abnormal inflammation, swelling or possible infection.

Artist Name *

Artist Email *

CLIENT INFORMATION

Client Name *

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Client Email *

Email

Confirm Email

Client Phone

Client D.O.B *

Gender *

Male
Female
Other

Race *

Tattoo/Piercing Requested(Design/Location)

Client Photo ID Upload

Click or drag a file to this area to upload.

Signature *

Date Signed *

CLIENT EMERGENCY INFORMATION

Name *

First

Last

Phone

MEDICAL INFORMATION

For the following question, please select “Health Central” if you do not have a personal physician you’d like to list.

Personal Physician *

Health Central Hospital | 10000 W Colonial Dr, Ocoee, FL 34761 | 407-296-1000
Other

If Other , Please list Physician info *

Include name, address, phone number

MEDICAL HISTORY

If none apply, please input NA.

Allergies *

Bleeding Disorders *

Medical Condition/ Diseases *

Medications *

Date of Service *

AFTERCARE TREATMENT FOR YOUR TATTOO

Leave the tattoo bandaged for a minimum of 2 hours.
Gently remove bandage under warm running water to reduce the risk of damaging the tattoo. Once bandage is removed, using an unscented soap, wash the tattoo off well with your hand and warm soapy water.
When done washing the tattoo off, gently pat the tattoo dry with a clean towel and allow the tattoo to air dry for about 5-10 minutes. Apply lotion: After Inked, H2Ocean,
Nat-A-Tat2, Saniderm, Sorry Mom, Curel, Lubriderm, (any fragrance free lotions) 4-6 times a day. The lotion can be applied to the tattoo daily for about 10-14 days or
until the tattoo is finished peeling.
Once bandage is completely removed DO NOT rebandage the tattoo.
No direct sunlight on tattoo for first 2-3 weeks. DO NOT pick or scratch tattoo while it is peeling. DO NOT soak the tattoo for 2 weeks. No swimming, baths, hot tubs or saunas for 2 weeks.
NO shaving or waxing area until tattoo is completely healed. DO NOT apply alcohol, Vaseline, Petroleum Jelly or sun block to fresh tattoo. No washing tattoos in the restrooms. Leave your bandage on until you can cleanly wash the tattoo off at home, or have the artist wash and rebandage. DO NOT listen to friends or so-called tattoo experts. If you have questions call or visit the artist that did your tattoo!
Once you leave the show proper care of your tattoo is your responsibility!
Consult a health care professional at the first sign of infection.
Symptoms of infection are fever, swelling, redness, or drainage occur.
There is always the possibility of an allergic reaction to some of the tattooing pigments.