←

Tattoo Release Form

Let us do this part
Today's Date:
Thu Apr 24 2025 04:17
Practitioner:*
Please read and answer
ARE YOU SICK?
IF YOU HAVE:
- a fever
- sore throat
- flu-like symptoms
- shortness of breath

***PLEASE BRING IT TO OUR ATTENTION AND WE WILL GLADLY GET YOU RESCHEDULED***


IF YOU CAN NOTIFY US AHEAD OF TIME PLEASE DO NOT COME IN FOR YOUR APPOINTMENT. YOU NEED TO NOTIFY STAY TRUE TATTOO OR YOUR ARTIST WITHIN 48 HOURS BEFORE YOUR APPOINTMENT.
Food
It's a good idea to eat within 4 hours before your tattoo to increase your blood sugar levels.
Y
N
Bloodbourne Pathogens*
Do you have any bloodbourne pathogens, transmittable diseases or recent illnesses? (It's okay if you do, we just want to know for our and other's safety).
Risks*
I have been fully informed of the inherent risks, associated with getting a tattoo. I fully understand that these risks, known and unknown, can lead to injury, including but not limited to infection, scarring, difficulties in detecting melanoma and allergic reactions to tattoo pigment, latex gloves, and/or soap, blistering, burning, ink spreading under the skin, ingrown hair, skin discoloration. Having been informed of the potential risks, I still wish to proceed with the tattoo application and I freely accept and expressly assume any and all risks.
Waive*
TO WAIVE AND RELEASE to the fullest extent permitted by law each of the Artist and Stay True Tattoo LLC from all liability whatsoever, for any and all claims or causes of action that I, my estate, heirs, executors or assigns may have for personal injury or otherwise, including any direct and/or consequential damages, which result or arise from my tattoo, whether caused by the negligence or fault of either the Artist or Stay True Tattoo LLC, or otherwise.
Healing*
The Artist and Stay True Tattoo LLC have given me instructions on the care of my tattoo while it's healing, and I understand them and will follow them. I acknowledge that it is possible that the tattoo can become infected, particularly if I do not follow the instructions given to me. If any touch-up work to the tattoo is needed due to my own negligence, I agree that the work will be done at my own expense.
Influence*
I will not be under the influence of alcohol or drugs, and I am voluntarily submitting to be tattooed by the Artist without duress or coercion.
Health*
I do not have diabetes, epilepsy, hemophilia, a heart condition, nor do I take blood thinning medication. I do not have any other condition that may interfere with the application or healing of the tattoo. I am not the recipient of an organ or bone marrow transplant or, if I am, I have taken the preventive anti-biotics. I am not pregnant or nursing. I do not have a mental impairment that may affect my judgment in getting the tattoo. If I do have any of the previous listed health conditions or any other, I will explicitly inform the artist and Stay True Tattoo LLC to see if it is still possible for me to get tattooed and I agree that I may need an approval note from my doctor granting me permission to get tattooed and therefore will possibly have to cancel or reschedule my appointment.
Spelling*
The Artist nor Stay True Tattoo LLC is not responsible for the meaning, spelling, or misspelling of the symbol or text that I have provided to them and the Artist nor Stay True Tattoo LLC is not responsible of the final design to be tattooed.
Fading*
Variations in color/design may exist between the art I have selected and the actual tattoo. I also understand that over time, the colors and the clarity of my tattoo will fade due to natural dispersion of pigment under the skin. I agree and understand that we define a "touch up" as shortly after the tattoo heals where any pigment may have fallen out/lightened is defined as a touch up. I agree that after 3 months from the date that the tattoo was done that it is not actually a touch up any more but considered a rework and will be paid at my own expense. This also includes HAND/FINGER/INNER LIP tattoos, we DO NOT do free touch ups on anything below the wrist, or inner lip. The reason is because you have a high probability of the tattoos fading quickly. By checking this box you agree, understand, and have been explained and given the opportunity to ask any questions you have for defining, explaining and understanding any tattoo including hand, finger, and lip tattoos and you still would like to continue in getting the tattoo.
Permanent*
A tattoo is a permanent change to my appearance and can only be removed by laser or surgical means, which can be disfiguring and/or costly and which will not result in the restoration of my skin to what it was prior to getting tattooed. It can cause scaring and keloid scaring in some individuals, I do acknowledge and agree to get tattooed knowing this is a possibility.
Legal Action*
I agree to reimburse each of and both the Artist and Stay True Tattoo LLC for any attorneys' fees and costs incurred in any legal action I bring against either the Artist or Stay True Tattoo LLC and in which either the Artist or Stay True Tattoo LLC is the prevailing party. I agree that the courts of Chester County Pennsylvania shall have personal jurisdiction and venue over me and shall have exclusive jurisdiction for the purpose of litigating any dispute arising out of or related to this agreement.
Consent*
I acknowledge that I have been given adequate opportunity to read and understand this document, that any and all of my questions have been answered, that it was not presented to me at the last minute, and I understand that I am signing a legal contract waiving certain rights to recover against the Artist and the Tattoo Studio.
Photography*
I release all rights to any photographs taken of me and the tattoo and give consent in advance to their reproduction in print or electronic form. (If you do not tick this provision, please advise your Artist).
Cancel*
I agree that I understand that the Artist or Stay True Tattoo LLC reserves the right to cancel my appointment or multiple appointments at any time without reason or explanation.
If any provision, section, subsection, clause or phrase of this release is found to be unenforceable or invalid, that portion shall be severed from this contract. The remainder of this contract will then be construed as though the unenforceable portion had never been contained in this document.
Client Information
I hereby declare that I am of legal age (with valid proof of age) and am competent to sign this Agreement.
Legal Name:*
Pronoun:
Chosen name:
Address:*
Postcode:*
Date of birth:*
You must be 18 or older
Phone #:*
Email:*
Signature:*


Emergency Contact
If something happens, your emergency contact might need to explain your medical history, allergies, or medications.
Name:
Phone #:
Photo ID*
Please take photo(s) of your government issued photo IDs and related paperwork.