top of page

KTC Tattoo & Piercing Consent form

Please fill out all the information below to the best of your ability

Have you been Tattooed before?
Have you been Pierced before?
Are you pregnant or Breastfeeding?
Do you have a heart condition, epilepsy or diabetes? (If yes Please Name:)
Are you a hemophiliac (bleeder) or do you have any known conditions that may cause bleeding or hinder blood clotting? If YES please name:
Do you have any communicable diseases (HIV, AIDS, Hepatitis, (Please be honest) If yes please name:
Do you have any allergies to medication or topical solutions? (If yes please name:)
Are you under the influence of alcohol or drugs prescription or otherwise? (If yes please name:)
preferred pronoun:
I was offered a patch test and refused (Cosmetic Tattoo's)
bottom of page