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Disclaimer Form

Disclaimer form

To be completed by the person wishing to be tattooed or pierced.

Name

Address

Phone

Date of birth

Email

Area of procedure

ID (passport/driving licence) seen?

Yes

No

Free Text

To my knowledge I do not suffer of have suffered from any of the following:

Eczema/impetigo

Yes

No

Haemorrhaging

Yes

No

Epilepsy (seizures)

Yes

No

HIV infection

Yes

No

Hepatitis A, B or C

Hepatitis A

Hepatitis B

Hepatitis C

None

Acne/psoriasis

Yes

No

Consumed any alcohol or hard drugs today

Yes

No

Allergic responses

Free Text

If you are suffering from any of the above you should consult your GP before proceeding with the tattoo or piercing

This is to certify that I (above named person) am over the age of 18 (tattoo) or 16 (piercing) and do hereby give my permission to be tattooed/pierced and that I am fully aware of the process involved and understand the importance of the aftercare procedure that has or will be explained to me by the practitioner

Yes

Name

Date

Thank you for filling out this form.

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Get In Touch

info@inkfusiontattoos.co.uk

01189 796100

Unit 44 Space Business Centre,

Molly Millars Lane,

Wokingham, Berkshire, RG41 2PQ

Mon - Thu: 10:00 am - 6:00 pm
Fri - Sat: 10:00 am - 4:00 pm
Sunday: Closed

Disclaimer Form

Name

Phone

Email

Design Reference

Message

Select Artist/Service

Thank you for contacting us.

We will get back to you as soon as possible.

Please note deposits are non-refundable. Deposits are applied to the cost of the tattoo. If you cancel, do not show or do not give at least 48 hour notice to reschedule, your deposit will be forfeited.

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