Client Consent Form | tomwilsontattoos.co.uk

Client Name *

Client Date Of Birth (dd/mm/yy) *

Client Email Address *

Date Of Procedure *

Client Contact Number *

Tattoo Practitioner Name *

Site Of Procedure (Location of tattoo) *

Do you have any medical conditions, or currently have any covid 19 symptoms (high temperature, a new, continuous cough and a loss or change to your sense of smell or taste). *

Yes (If yes please provide more information on your medical conditon below.

If you answered yes and have any medical conditions please provide details below.

I declare that I give my full consent to the tattooing being carried out by the aforementioned practitioner. I confirm that potential complications, e.g. infection and swelling, for the procedure undertaken, and aftercare instructions have been explained to me. A written aftercare advice sheet containing more detailed information has been given to me and I agree that it is my responsibility to read this and follow the instructions on it, until the site has healed. I confirm that the above information provided by me for this consent form is correct to the best of my knowledge, that I am over the age of consent for this procedure (i.e. 18 years old for tattoos) and that I am not currently under the influence of alcohol or drugs. *

I have read the above statement and I DO give consent.

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Email us: tattooenquiry@tomwilsontattoos.co.uk