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Tattoo Record & Release Form: Notary If Needed

The document is a tattoo record and release form for Bad to the Bone Tattooing. It collects information about the client such as name, age, address, phone number, allergies and emergency contact. The client agrees to hold the tattoo parlor harmless for any risks or complications from the procedure. They also agree to follow the recommended aftercare instructions. Minors under 18 require a notarized form from a parent or guardian, and no one under 16 will be tattooed. The form records details of the specific tattoo including location, price and condition of the skin.

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Jessica Vazquez
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© Attribution Non-Commercial (BY-NC)
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88 views1 page

Tattoo Record & Release Form: Notary If Needed

The document is a tattoo record and release form for Bad to the Bone Tattooing. It collects information about the client such as name, age, address, phone number, allergies and emergency contact. The client agrees to hold the tattoo parlor harmless for any risks or complications from the procedure. They also agree to follow the recommended aftercare instructions. Minors under 18 require a notarized form from a parent or guardian, and no one under 16 will be tattooed. The form records details of the specific tattoo including location, price and condition of the skin.

Uploaded by

Jessica Vazquez
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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TATTOO RECORD & RELEASE FORM

I, the undersigned, agree of my own free will to the performance of the above procedure by
Bad to the Bone Tattooing.
DATE: ______/________/_______.
The procedure has been explained to me along with its inherent risks. I understand an
agree to hold harmless and release from liability Bad to the Bone Tattooing and it's staff and
employee's for any event, after-effect, or consequence arising from the above procedure. If all
questions have been answered please initial.____________
An after-care regiment has been explained to me at the time of the procedure and I agree to
follow it as recommended. I understand an agree to hold harmless and released from liability
Bad to the Bone Tattooing and it's staff and employee's for any event, after-effect or
consequence arising from the above procedure. If you understand and agree please
initial.____________
Minors: Anyone under the age of 18 must have a notarized form from a parent or legal
guardian. No one under the age of 16 will be tattooed.
NAME:______________________________ AGE:________ DOB: ______/_______/______
ADDRESS:____________________________ CITY:__________ STATE:______ ZIP:_______
PHONE:__________________ SEX: M_____ F_____
RACE: WH_____ BLK_____ HSP____ ASIAN_____ OTHER_____
ANY ALLERGIES TO: Bacitracin, Bag Balm, Isopropyl Alcohol, Benzocaine, Lyidocaine, Green
Soap, Any Type Of Ink Or Dye, other:_______________.
IN CASE OF EMERGENCY PLEASE CONTACT: ____________________________________
ADDRESS/PHONE:_____________________________________________________________
SIGNATURE:_______________________________
TATTOO PERFORMED BY:_________________ TYPE OF TATTOO:____________________
PRICE OF TATTOO:________________________ LOCATION:_________________________
CONDITION OF SKIN AT TATTOO SITE: _________________________________________
NOTARY IF NEEDED
NAME OF MINOR:_______________ PARENT OR GUARDIAN:_______________________
THIS SIGNATURE NOTARIZED BEFORE ME ON THIS DATE:_______/_______/________

NOTARY SIGNATURE:________________________
PRINTED NAME: _____________________________

(SEAL)

ANY COMPLICATIONS DURING PROCEDURE:____________________________________

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