Exquisite Ink Tattoo Studio Consent Form
Let us do this part
Today's Date:
Fri Apr 4 2025 05:35
Practitioner:*
Exquisite Ink Tattoos Consent Form

Thank you for Choosing Exquisite!!
Please read and answer
Are you getting a TATTOO or PIERCING??*
 

How did you hear about us?*
 

Y
N
Do you have Flu like symptoms?*
IF YOU HAVE:
- a fever
- flu-like symptoms
- shortness of breath

YOU NEED TO NOTIFY A STAFF MEMBER IMMEDIATELY.

Y
N
Eaten*
Have you eaten in the past 4hrs? It's a good idea to before hand to increase your blood sugar levels.

Y
N
Bloodbourne Pathogens*
Do you have any bloodbourne pathogens, transmittable diseases or recent illnesses? (It' okay if you do, we just want to know for our and other's safety).

Risks*
That I have been fully informed of the inherent risks, associated with getting a tattoo. I fully understand that these risks, known and unknown, can lead to injury, including but not limited to infection, scarring, difficulties in detecting melanoma and allergic reactions to tattoo pigment, latex gloves, and/or soap. Having been informed of the potential risks, I still wish to proceed with the tattoo application and I freely accept and expressly assume any and all risks.

Waive*
TO WAIVE AND RELEASE to the fullest extent permitted by law each of the Artist and the Studio from all liability whatsoever, for any and all claims or causes of action that I, my estate, heirs, executors or assigns may have for personal injury or otherwise, including any direct and/or consequential damages, which result or arise from my tattoo, whether caused by the negligence or fault of either the Artist or the Tattoo Studio, or otherwise.

Healing*
The Artist and the Tattoo Studio have given me instructions on the care of my tattoo while it's healing, and I understand them and will follow them. I acknowledge that it is possible that the tattoo can become infected, particularly if I do not follow the instructions given to me. If any touch-up work to the tattoo is needed due to my own negligence, I agree that the work will be done at my own expense.

Influence*
I am not under the influence of alcohol or drugs, and I am voluntarily submitting to be tattooed by the Artist without duress or coercion.

Health*
I do not have diabetes, epilepsy, hemophilia, a heart condition, nor do I take blood thinning medication. I do not have any other condition that may interfere with the application or healing of the tattoo. I am not the recipient of an organ or bone marrow transplant or, if I am, I have taken the preventive anti-biotics. I am not pregnant or nursing. I do not have a mental impairment that may affect my judgment in getting the tattoo.

Spelling*
Neither the Artist nor the Tattoo Studio is responsible for the meaning or spelling of the symbol or text that I have provided to them or chosen from the flash (design) sheets.

Fading*
Variations in colour/design may exist between the art I have selected and the actual tattoo. I also understand that over time, the colors and the clarity of my tattoo will fade due to natural dispersion of pigment under the skin.

Permanent*
A tattoo is a permanent change to my appearance and can only be removed by laser or surgical means, which can be disfiguring and/or costly and which in all likelihood will not result in the restoration of my skin.

Legal Action*
I agree to reimburse each of the Artist and the Tattoo Studio for any attorneys' fees and costs incurred in any legal action I bring against either the Artist or the Tattoo Studio and in which either the Artist or the Tattoo Studio is the prevailing party. I agree that the that the courts of TEXAS in UNITED STATES OF AMERICA shall have personal jurisdiction and venue over me and shall have exclusive jurisdiction for the purpose of litigating any dispute arising out of or related to this agreement.

Questions*
I acknowledge that I have been given adequate opportunity to read and understand this document, that any and all of my questions have been answered, that it was not presented to me at the last minute, and I understand that I am signing a legal contract waiving certain rights to recover against the Artist and the Tattoo Studio.

Photography*
I release all rights to any photographs taken of me and the tattoo and give consent in advance to their reproduction in print or electronic form. (If you do not tick this provision, please advise your Artist).

Tattoo & Piercing AfterCare *
TATTOO AFTERCARE:

Now, you have a fresh new tattoo, and want to take good care of it! Here you will find
instructions for aftercare, whether you have had Saniderm applied or not. It is very important that
you follow these guidelines. A “REALLY” beautiful tattoo can turn into a disaster if the proper
aftercare is not taken care of properly. New tattoos are open wound, and tattoo aftercare plays a
critical role in how efficiently the wound heals
WITH SANIDERM
Saniderm will seal in your body’s natural fluids to help reduce the healing time.
• Leave Saniderm on a full 24 hours (unless redness starts to show around the wrap or
instructed by your artist)
• Remove Saniderm in the shower/with warm running water
• Once removed, wash with anti-bacterial soap 3-4x daily
• Apply ointment or cream: Aquaphor or Lubriderm lotion
WITHOUT SANIDERM
• For at least two weeks, the need to minimize exposure to the sun, and to discourage
swimming.
• Properly cleanse the tattooed area with anti-bacterial soap 3-4x daily
• Apply antibiotic ointment or cream; Aquaphor or Lubriderm lotion
• Use sterile bandage(s) or other sterile dressing(s) when necessary.
• Artist Name _________________, @ Exquisite Ink Tattoo Studio 18817 FM 2252 San
Antonio Tx 78266, (210)254-9684 and
• Clients shall consult a health care practitioner at the first sign of infection or an allergic
reaction, and to report any diagnosed infection, allergic reaction, or adverse reaction
resulting from the application of the tattoo to the artist and to the department at 1-888-
839-6676.

BODY PIERCING AFTERCARE
• Properly cleanse the pierced area by using antibacterial or antimicrobial soap for the
external skin or an antiseptic or saltwater mouthwash for the oral cavity.
• For at least the first six weeks, minimize exposure to filth.
• Use sterile bandage(s) or other sterile dressing(s) when necessary.
• Artist Name__________________ @ Exquisite Ink Tattoos Studio 18817 FM 2252 San
Antonio Tx 78266, (210)254-9684 and
• Clients shall consult a health care practitioner at the first sign of infection or an allergic
reaction, and to report any diagnosed infection, allergic reaction, or adverse reaction
resulting from the body piercing to the artist and to the department, at 1-888-839-6676.

Touch up for all Tattoo's (21 Day Grace Period)*
As far as touch ups goes for all TATTOO'S we will have a grace period of 21 days that should give the tattoo plenty of days to heal so if you're tattoo needs a touch up it needs to be done before the 21days

If the time expires after the 21 days sure we can do the touch-up, but we will have to charge after the grace period of 21days!

If any provision, section, subsection, clause or phrase of this release is found to be unenforceable or invalid, that portion shall be severed from this contract. The remainder of this contract will then be construed as though the unenforceable portion had never been contained in this document.
Client Information
I hereby declare that I am of legal age (with valid proof of age) and am competent to sign this Agreement.
Name:*
Date of birth:*
 
You must be 18 or older
Age: 
Phone #:*
Email:*
Signature:*

Emergency Contact
If something happens, your emergency contact might need to explain your medical history, allergies, or medications.
Name:
Phone #:
Photo Identification *
Please take photo(s) of your government issued photo IDs and related paperwork