Fine Line Tattoo / Flash Tattoo Consent

I. THE POSSIBILITY OF DISCOMFORT OR PAIN

II. THE PERMANENCE OF THE MARKINGS

III. THE RISK OF INFECTION

IV. THE POSSIBILITY OF ALLERGIC REACTION THE THE PIGMENTS OR OTHER MATERIALS USED

Date / Time

Patient Name

First

Middle

Last

Patient's gender

Patient Phone

If you need an appointment for someone under 18, please provide your own contact details.

Patient Email Address

Email

Confirm Email

If you need an appointment for someone under 18, please provide your own contact details.

Patient's Current Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

PLEASE TYPE YOUR FULL NAME:

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Please upload a valid driver's license or another form of government issued ID:

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