consent form

Tattoo Consent Form

Version 1

Issued 22/10/2026

Draft. Not yet approved by the studio's qualified practitioner. Do not issue to clients.

Please read this form carefully and ask us about anything you do not understand. Initial each statement, answer every question, then sign. You can change your mind at any point. If you prefer to discuss any answer in private, tell your artist.

Your details

Full name: ______________________________

Date of birth: ______ / ______ / ____________

Email: ______________________________

Telephone: ______________________________

Booking reference: ______________________________

Design and placement: ______________________________

Declarations

1. I confirm that I am 18 years old or over. (Initials: ______)

2. I have shown my artist valid photographic ID, and it matches the name and date of birth above. (Initials: ______)

3. I understand that the studio will not tattoo anyone under 18, and that nobody else can give consent for me. (Initials: ______)

4. I am not under the influence of alcohol or drugs. (Initials: ______)

5. I have answered the health questions below honestly and completely, and I have told my artist about any medicine I take. (Initials: ______)

6. I have seen the design and the stencil placement, and I am happy with both. I understand that I can ask for changes before the tattoo starts. (Initials: ______)

7. I understand that a tattoo is permanent. Removal is difficult, can be expensive and may not be complete. (Initials: ______)

8. My artist has explained the risks, including infection, an allergic reaction to ink, scarring, keloid scars, colours healing differently from how they look at first, uneven or patchy healing, and pain. (Initials: ______)

9. I understand that every tattoo heals differently, and that my skin, my aftercare and my own health affect the result. (Initials: ______)

10. I have seen new, sterile, single-use needles opened for my tattoo, or I have been told I can ask to see them. (Initials: ______)

11. I have received written aftercare instructions, and my artist has explained how and when to remove the dressing. I will follow them, and I will contact the studio, my GP or NHS 111 if I am worried about healing. (Initials: ______)

12. I understand that I can ask to stop at any time. (Initials: ______)

13. I have read the Deposits, Cancellations and Refunds guide. I understand that this form does not affect my legal rights. (Initials: ______)

14. I have been told how the studio uses my personal information, and where to find the Privacy Notice. (Initials: ______)

Photographs

Circle Yes or No for each. You can change your mind later, and this does not affect your tattoo.

Photographs of my tattoo for my private record, and to help my artist check healing. Yes / No
Photographs shared on the studio portfolio or website. Yes / No
Photographs shared on the studio social media. Yes / No

Health history

Please circle Yes or No. If you answer Yes to any question, tell your artist. It does not always mean that we will say no.

Are you pregnant, breastfeeding or trying to conceive? Yes / No
Do you have a bleeding or clotting disorder, or do you take blood-thinning medicine? Yes / No
Do you have diabetes? Yes / No
Do you have a heart condition or heart valve problem? Yes / No
Do you have epilepsy, or do you faint easily? Yes / No
Do you have a weakened immune system, or take medicine that lowers it (including steroids, or chemotherapy)? Yes / No
Do you have a history of keloid or very raised scars? Yes / No
Do you have a skin condition, such as eczema, psoriasis or dermatitis? Yes / No
Do you have sunburn, a rash, a cold sore, an infection or broken skin at the tattoo site? Yes / No
Are you taking, or have you recently stopped taking, isotretinoin (acne medicine)? Yes / No
Have you had surgery or hospital treatment in the last six months? Yes / No
Are you allergic to latex, adhesives, metals, antiseptics or pigments, or have you reacted to a tattoo before? Yes / No
Are you unwell today, with a fever, cold or flu? Yes / No
Have you eaten today? Yes / No
Is there anything else we should know? Yes / No

If you answered Yes to anything, please give details: ______________________________

Your signature

Client signature: ______________________________

Date: ______ / ______ / ____________

Practitioner section

Practitioner name: ______________________________

Licence or registration number: ______________________________

Registering council: ______________________________

ID checked (type and expiry): ______________________________

Area tattooed: ______________________________

Needle or cartridge lot number: ______________________________

Pigment batch numbers: ______________________________

Dressing used and removal advice: ______________________________

Aftercare given (written and verbal): Yes / No

Practitioner signature: ______________________________

Date: ______ / ______ / ____________

Practitioner to confirm: the studio's tablet consent form is the main record. Use this paper version when the tablet is not available, or to print for the client. Paper health answers are sensitive information, so confirm how and where they are stored, for how long, and who may see them. Confirm the health questions, the isotretinoin question and the photograph options with the insurer, and confirm the registering council and the number fields required by local byelaws.

Questions? Email thedesk@rebelliousink.tattoo. For anything medical, contact NHS 111 or your GP. In an emergency, call 999.