Tattoo / Piercing / Toothgems (check all that apply)*
It is shop policy that clients without a valid picture ID (Driver License, State, Military ID, Passport, etc.) regardless of age will not be tattooed/pierced. This document will be kept on file for (3) years of visit. It is kept for Health Department regulations only. It has the same client privilege as any hospital or doctor’s office and is not to be used or release to any law enforcement agency, mailing, or phone list, or for any other public or private use. There will be a $5.00 surcharge for any tattoo and a $3.00 surcharge for any piercing. This charge is to offset the cost of sanitation materials we use to ensure hygiene & safety. All touch up appointments will be charged a minimum of $10.00
Immuno compromised or neurological compromised?*
Skin diseases or lesions?*
Allergies or adverse reactions to pigments, dyes, disinfectants, soaps, or metals?*
History of epilepsy, seizures, fainting, or narcolepsy?*
Taking anticoagulants or any other medications that may thin the blood and/or interfere with blood clotting?*
Do you have any other concerns regarding any other medical issues you may have?*
If under 18 years of age, parental or legal guardian must sign in person & present legal documentation of such (Driver License, State, Military ID, Passport, etc)
