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Only to be filled out on the day of your appointment*

Consent FORM

Medical conditions:
Eczema, Psiorisis, Cellulitis or other skin conditions:
Heart disorders:
High/Low blood pressure:
Haemophilia or other bleeding disorders:
Epilepsy or any other form of seizures:
Diabetes:
Hepatitis:
Autoimmune disease or a treatment causing it (eg. chemotherapy):
Allergies:
Pregnant or nursing:
Taking medication:
Mental health conditions:

FOR CLIENT INFORMATION

Potential risks associated with tattoos:​

  • Allergic reactions. Tattoo dyes — especially red, green, yellow and blue dyes — can cause allergic skin reactions, such as an itchy rash at the tattoo site. This can occur even years after you get the tattoo.

  • Skin infections. A skin infection is possible after tattooing as with any other open wound.

  • Other skin problems. Sometimes an area of inflammation called a granuloma can form around tattoo ink. Tattooing also can lead to keloids — raised areas caused by an overgrowth of scar tissue.

  • MRI complications. Rarely, tattoos or permanent makeup might cause swelling or burning in the affected areas during magnetic resonance imaging (MRI) exams. In some cases, tattoo pigments can interfere with the quality of the image.

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