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TATTOOING CONSENT FORM

Check off any conditions which apply to you:








By signing this form I agree to the following:

I agree to follow all verbal and/or written instructions concerning the care of my tattoo. Any touch-up work that needs to be done due to my own negligence will be at my own expense. This includes using things like numbing cream. If my skin is dark, it will affect the intensity and color of the tattoo. I do not have Any mental, physical, or medical impairment which may affect my judgment or my well-being as a direct or indirect result of my Decision to have tattoo work performed at this time. Keepsake Custome Tattoo Inc. and it's artists, contractors, and employees should not be held responsible for any claims, damages, actions, judgments, litigation costs, attorney’s fees, and all other cost expenses which might arise from my decision to have a tattoo work done at this time.

By signing this form, I hereby certify that, to the best of my knowledge, the information I have provided is correct. I certify that I am at least 18 years of age and will provide legal identification to be photocopied and attached to this form. I certify that all questions have been answered to my satisfaction. By submitting this form I release all rights to any photographs/videos taken of me and my tattoos. I also give consent in advance to their reproduction in prints and social media.


Tattoo Pricing & Service Time Policy

Our pricing structure is inteneded to create a professional, relaxed environment where artists can focus on doing their best work without being rushed. Tattoo services are priced based on the time, effort, preparation, and service provided by the artist. We do not offer flat-rate pricing, and any estimate provided is only an estimate.

Throughout the booking process, we strive to understand what you are looking for through our booking form and phone consultations. We also provide opportunities to make edits or updates before your appointment at no additional charge, including automated reminders encouraging clients to contact the studio ahead of time with any changes or updates. While we do not charge for the time spent creating and preparing your tattoo design before your appointment, we do charge for the time and services provided during your appointment, including time spent placing stencils, reviewing new reference photos, making last-minute adjustments, or handling day-of design changes, to ensure artists are fairly compensated for their time and effort.

I understand that appointment time may increase due to factors such as multiple stencil adjustments, multiple placement changes, day of design edits, multiple breaks, movement during the tattoo, or additional consultation time during the appointment. Small last-minute changes are part of the process, and artists are happy to make reasonable adjustments, but additional time may increase the final cost of the tattoo.

I understand that appointments over the studio minimum of $100 for 30 minutes of tattooing include a 15-minute service time fee to help account for required setup and cleanup procedures performed for each tattoo. I also understand that this pricing structure was disclosed during booking, within the app info link I was sent with my booking confirmation and has been referenced again through appointment reminders and this consent form. The studio will use appointment monitoring and security cameras to ensure accurate timing and fairness for both the clients and the artists.

I understand that the studio may have sent this consent form ahead of my appointment so I have adequate time to carefully review and understand studio procedures and pricing policies before arriving.


Free Touch-up Policy

I acknowledge that tattoos performed on scars, cover-ups, blackouts, elbows, ears, lips, fingers, hands, and feet tattoos are considered more difficult and unpredictable areas to tattoo. These areas often require multiple sessions or additional work after healing to achieve the best possible result.

I understand that, in many cases, the safest and most effective approach is to tattoo the area, allow it to fully heal, and then make adjustments or add additional saturation afterward rather than overworking the skin during the initial appointment. This helps reduce unnecessary skin trauma and allows the artist to evaluate how the skin heals and retains ink before continuing.

Because these types of tattoos commonly require additional sessions or touch-up work, they are not covered under the studio’s free touch-up policy. Any additional work or rework on the areas listed above will be charged based on the time required to perform the work. This explanation is in addition to the appointment information provided by text message and email after booking.


I understand that touch-ups or rework for the types of tattoos listed above are not covered under the studio’s free touch-up policy and would be charged based on the time required to perform the work. This explanation is in addition to the appointment information provided by text message and email after booking.


READ ABOVE TOUCH UP POLICY!!


Numbing Cream Policy

I agree that if I use a numbing cream or any other 3rd party product, I do so at my own risk, assuming all responsibility for any reaction or poor healing and sacrificing my free touch-up. We will not do free touch-ups on a tattoo that healed poorly due to numbing cream.


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BOARD OF HEALTH - BODY ART DISCLOSURE STATEMENTS

This statement is to be given to all body art clients, and is to be signed by the client, prior to performing any body art procedure.


TATTOO DISCLOSURE STATEMENT

As with any invasive procedure, tattooing may involve possible health risks. Pain, bleeding, febrile illness, tetanus, systemic infection, swelling, infection, scarring of the area, and nerve damage. Un-sterile equipment and needles can spread infectious diseases; it is extremely important to be sure that all equipment is clean and sanitary before a use. Tattoos and permanent makeup are not easily removed and, in some cases, may cause permanent discoloration. Think carefully before getting a tattoo. There is also the possibility of an allergic reaction. The inks or dyes used for tattoos are color additives. Currently, no color additives have been approved by FDA for tattoos, including those used in permanent makeup. Blood donations cannot be made for a year after getting a tattoo or permanent makeup.

THE BODY ART PRACTITIONER SHOULD

Properly and thoroughly cleanse the area before the procedure. Use sterilized equipment. Use sterile techniques. Provide information on the aftercare of the area receiving body art.

HEALTH HISTORY AND INFORMED CONSENT

The following conditions may increase health risks associated with receiving body art:


  1. diabetes
  2. hemophilia (bleeding)
  3. skin diseases, lesions, or skin sensitivities to soaps, disinfectants etc.
  4. history of allergies or adverse reactions to pigments, dyes, or other sensitivities
  5. history of epilepsy, seizures, fainting, or narcolepsy;
  6. use of medications such as anticoagulants. (such as coumadin) which thin the blood and/or interfere with blood clotting; and
  7. hepatitis or HIV infection

PROCEDURE FOR FILING A COMPLAINT

If there is any injury, infection, complication or disease as a result of a body art procedure notify this establishment and the following local board of health at Salisbury Health Dept., 5 Beach Road, Salisbury, Massachusetts 01952. Phone: 978-462-3430

CLIENT CONFIRMATION

I have received the above information; I do not have a condition that prevents me from receiving body art. I consent to the performance of the body art procedure and will be provided written and verbal aftercare instructions.

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