Consent FormThings we’d like to ensure you know and understand before getting a tattoo in our space Tattooing involves breaking the skin, one of your body’s main protective barriers. This means you may be more susceptible to skin and blood infections such as: * Bloodborne diseases - including hepatitis C, hepatitis B, tetanus and HIV, the virus that causes AIDS. Skin infections - Ranging from minor to potentially serious antibiotic resistant infections. Symptoms may include redness, swelling, or pus-like drainage. Granulomas. Bumps may form around the site of the tattoo as a reaction to the ink. Scars and keloids. raised, ridged areas caused by overgrowth of scar tissue Allergic reactions - The ink may cause an itchy rash at the tattoo site. Swelling or burning. Tattooed areas may swell or burn during Magnetic resonance imaging (MRI) exams. I understand If abnormal itching, irritation, redness, swelling or fever should appear, please contact a physician immediately. These could be signs of a potentially serious medical condition that should be addressed. Ok To ensure that your body art procedure heals properly, we ask that you disclose if you have or have had any of the following conditions. Disclosure absolutely and legally does not prevent you from having a body art procedure Diabetes * yes no History of hemophilia (bleeding) * yes no History of skin diseases, skin lesions, or skin sensitivities to soaps, disinfectants, etc. * yes no History of allergies or adverse reactions to pigments, dyes or other skin sensitivities such as latex * also inform your artist about any specific allergies yes no History of epilepsy, seizures, fainting or narcolepsy * yes no Use of medications, such as anticoagulants that thin the blood and/or interfere with blood clotting * yes no Human immunodeficiency virus (HIV) * yes no Hepatitis * yes no Name * First Name Last Name Dropdown * Rylee Sky Young Rick Zacchi guest If guest artist, please add thier name Date * MM DD YYYY Thank you!