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Complete the consent form below prior to your appointment with Debut Studios
First Name
Last Name
Email
Address
Phone
Birthday
Tattoo Description & Placement
Artist name
How did you find Debut Studios?
*
Google
Instagram
TikTok
Word of Mouth
Through artist
Have you ever suffered from any of the following:
*
Required
Haemophilia or another bleeding/clotting disorder
HIV
Diabetes
Epilepsy or seizures
Fainting attacks
Keloid or abnormal scarring
Psoriasis
Cellulitis
Acne affecting the area to be tattooed
Eczema or dermatitis
Allergies or previous allergic reactions, including to latex, adhesives, creams, metals, pigments/dyes or topical products
Previous reaction to tattoo ink or pigment
Immunosuppression or a weakened immune system
Autoimmune condition
Current use of blood-thinning/anticoagulant medication
Current medication or medical treatment that may affect bleeding, healing or your immune system
Current infection, illness or fever
A rash, wound, infection, sunburn or other active skin condition in the area to be tattooed
Pregnancy
None of the above
Please provide details of anything selected above, or any other health condition, medication, allergy or information that may be relevant to your tattoo or its healing.
Please tick each statement below to confirm you have read and agree to each one.
I confirm that I have provided complete and accurate information about any health conditions, medications, allergies or other circumstances that may be relevant to the tattoo procedure or healing process. I understand that if I have disclosed anything that may affect the safety of the procedure, Debut Studios or my artist may require me to obtain appropriate medical advice before proceeding.
I confirm that I have been given the opportunity to ask any questions I may have about obtaining a tattoo and that any questions I have raised have been answered to my satisfaction.
I understand that tattooing involves breaking the skin and carries inherent risks, which may include pain, bleeding, swelling, bruising, infection, allergic or sensitivity reactions, scarring, changes in pigmentation, ink migration or “blowout”, and areas of pigment healing lighter or requiring additional work. I understand that individual healing and the final healed result can vary.
I understand that it is not always possible to predict whether I may experience an allergic or sensitivity reaction to tattoo pigments, inks or other products used during the procedure, and I accept that such reactions are possible.
I understand that tattoos are intended to be permanent and that subsequent alteration or removal may be difficult, costly and may not completely restore the skin to its previous appearance.
I understand that appropriate aftercare is important to the healing of my tattoo and reducing the risk of infection or other complications. I agree to follow the aftercare instructions provided to me and to seek appropriate medical advice if I develop signs of infection or another concerning reaction.
I confirm that I am 18 years of age or older and that the personal information and date of birth I have provided are accurate. I understand that Debut Studios may request valid photographic identification where age verification is required.
I confirm that I am not currently under the influence of alcohol, recreational drugs or any other substance that could impair my judgement or ability to give informed consent.
Promotional photography and video consent
*
Yes I consent to Debut Studios capturing photographs and/or video of me and/or my tattoo and using identifiable content for portfolio, website, social media, advertising and other promotional purposes.
No I do not consent to my identifiable image or video being used for promotional purposes. Choosing “No” will not affect your ability to receive your tattoo.
I confirm that the information I have provided is true and complete to the best of my knowledge. I understand the nature and permanence of the tattoo procedure and the associated risks, have had the opportunity to ask questions, and voluntarily give my informed consent to be tattooed.
Your Signature
Clear
SUBMIT
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