Tattoo Informed Consent

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Halo Tattoo Collective informed consent.

Today's date: *

YYYY

First & Last Name: *

Phone: *

Email: *

Date of birth: *

YYYY

Tattoo Description *

Where will your tattoo be placed on your body? *

Artist: *

Erika Jurkovic

Brittney Haili

Claire Anderson

Dakota Jenner

Isa Verri

Josh

Kayla

Martina Major

Melanie Christo

Wade Hex

Guest Artist

Other:

Required

Please read and check below: *

I am 18 years of age or older and I desire to receive the indicated permanent cosmetic or tattoo procedure.

I am not pregnant, nursing nor under the influence of drugs or alcohol.

If I have an immune disorder, hepatitis, other risk factors for bloodborne pathogen exposure, or any other communicable disease, I have informed the artist/technician of that fact. I have consulted my physician about the appropriateness of this procedure relative to my condition.

I understand that I will be given verbal aftercare suggestions. Aftercare instructions can also be found on our website www.HaloLongBeach.com. These instructions will include restrictions on physical activities such as bathing, recreational water activities, gardening, or contact with animals.

If I consent to having pictures taken of my tattoo procedure. They may be used by Halo Long Beach and it's associates for documentation or promotional purposes.

I understand that if I take an antibiotic before seeing a dentist or for similar service, I may need to do the same before my tattoo/permanent makeup procedure.

I release from liability and claims Halo Long Beach LLC and it's associates. If I have concerns about my tattoo or permanent make-up I will visit Halo Long Beach for advice. If I have other health concerns or issues I will visit a doctor.

I understand that the application of a tattoo will result in a permanent change to my appearance, and that needles and pigments will penetrate the surface of the skin. No representations have been made to me as to the ability to later restore the skin involved in the tattoo/permanent makeup to original condition.

I understand that some swelling and bruising may occur. Some people bruise or swell more than others. The swelling or bruising typically disappears in 1-5 days.

I do not have epilepsy, diabetes, an allergy to latex or antibiotics, hemophilia or other bleeding disorder. I do not have cardiac valve disease, suffer from any heart condition or take medications that thin my blood.

I have advised the artist of any allergies. I acknowledge that it is not possible to determine whether I might have an allergic reaction to the tattoo/permanent makeup procedure and acknowledge the such reaction is possible. I understand that the inks, dyes, and pigments have consequences of using these products are unknown.

I understand that tattoos placed on the FINGER are not guaranteed and might require a touch-up at additional cost.

I understand that there are no refunds or credits.

Required

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