consent form

Thank you for booking a tattoo with us!

Please complete ALL questions below within 24 hours before your tattoo appointment at Logan Square Tattoo.

We are always working to have minimal paperwork, a healthy and environmentally friendly approach and one way of doing so is to have clients fill out our Tattoo Consent Form online BEFORE you arrive at the studio.

This minimizes time in the studio and creates a touch less check-in process.

Logan Square Tattoo will need you to fill out the release form before we can proceed with your appointment. Please read through this Online Client Consent Form carefully, fill it out thoroughly and let us know if you have any questions or concerns before your tattoo consultation or appointment.

AS ALWAYS, YOU MUST BRING A VALID PHOTO ID TO YOUR APPOINTMENT AND BE AT LEAST 18 YEARS OF AGE

IT IS REQUIRED BY THE STATE OF ILLINOIS THAT YOU READ THE ILLINOIS DEPARTMENT OF HEALTH CONSENT FORM:

I acknowledge that I have fully read the State of Illinois Public Health form above and understand the risks. I will disclose any medical conditions in my answers below.

* By clicking here, I agree the above is true and correct. I acknowledge understanding of the above paragraph

First Name (Name on ID)

Preferred Name/Pronoun

Last Name

Phone number

Birthday

Street Address, City, State, Zipcode

Drivers License/State ID/Passport*

Upload VALID Drivers License, State ID or Passport. MUST BE 18 YEARS OF AGE OR OLDER This will be verified when you arrive so please bring your ID to your tattoo appointment. Please make sure the picture is clear and readable

Drivers License/State ID/Passport

Upload File

Emergency Contact & Phone Number

Guest Artist Name (If booked with a guest)

Appointment Date

Appointment Time

Customer acknowledges he/she/they will be given the full opportunity to ask any and all questions which he or she might have about obtaining a tattoo and that all of those questions will be answered to the customers full and total satisfaction. By clicking here, I agree the above is true and correct. I acknowledge and understand the above paragraph.

Customer acknowledges that she is not pregnant and Customer also acknowledges he or she is free from all communicable diseases.By clicking here, I agree the above is true and correct. I acknowledge and understand the above paragraph.

Customer acknowledges he/she/they is not intoxicated or under the influence of alcohol, any narcotic, medication, or any other substance, which could inhibit, prohibit, alter or hinder their understanding of anything read or agreed to in this Release and Waiver of All Claims.By clicking here, I agree the above is true and correct. I acknowledge and understand the above paragraph.

Customer acknowledges that he or she has truthfully represented to the employees, agents, and representatives of Logan Square Tattoo that he or she is 18 years or older in age and to the best of customer’s knowledge is currently in good health, such that Customer knows of no reason why he or she should not be tattooed today.By clicking here, I agree the above is true and correct. I acknowledge and understand the above paragraph.

Customer acknowledges that it is not reasonably possible for the employees, agents and representatives of Logan Square Tattoo to determine whether undersigned Customer might have an allergic reaction to the dyes, pigments, or processes used in the application of a tattoo and agrees to accept the risk that such a risk is possible. By clicking here, I agree the above is true and correct. I acknowledge and understand the above paragraph.

Customer acknowledges that I will advise my tattoo artist of any condition that might affect the healing of this tattoo. I will let the artist know if I have anything such as scarring, keloid, eczema, psoriasis, moles or sunburn in the area to be tattooed that may interfere with said tattoo. If I have any type of infection or rash anywhere on my body, I will advise my tattooer.By clicking here, I agree the above is true and correct. I acknowledge and understand the above paragraph.

Customer acknowledges that infection is always possible as a result of the obtaining of a tattoo, particularly in the event that he/she/they does not take proper care of their tattoo. That being said, Customer also acknowledges that the artist will go over aftercare instructions advising them of the proper care of their tattoo and furthermore recognizes the absolute necessity of following those instructions. Clients will also be given a link to aftercare instructions. .By clicking here, I agree the above is true and correct. I acknowledge and understand the above paragraph.

Customer acknowledges that variations in color and design may exist between any tattoos as selected by said customer and as ultimately applied to said customer’s body. I understand that skin tone influences how color is perceived and I will discuss color options with my artist before tattooing.By clicking here, I agree the above is true and correct. I acknowledge and understand the above paragraph.

Customer acknowledges that a tattoo is a permanent change to his or her appearance and that no representations have been made to Customer as to the ability to later change or remove Customer’s tattoo. To my knowldege, I do not have a physical, mental or medical impairment or disability which might affect my well being as a direct or indirect result of my decision to have a tattoo.By clicking here, I agree the above is true and correct. I acknowledge and understand the above paragraph.

I acknowledge that if my tattoo is a symbol, or something written in a language other than English, the tattoo artist and the owner of Logan Square Tattoo are not responsible for what it may or may not mean. By clicking here, I agree the above is true and correct. I acknowledge and understand the above paragraph.

I acknowledge that if my tattoo includes text, that I am responsible for the correct spelling, grammar and punctuation. I have proofed the text before it is applied as a tattoo

I acknowledge the decision for obtaining my tattoo is my own free will and choice. I consent to the location of the tattoo and the performance of the tattoo procedure. By clicking here, I agree the above is true and correct. I acknowledge and understand the above paragraph.

I agree to IMMEDIATELY notify the artist if I feel lightheaded, dizzy and/or faint before, during or after the procedure. Failure to do so releases Logan Square Tattoo and my tattoo artist of all responsibility.

Customer acknowledges the foregoing paragraphs and agrees to ask any questions, clear up any misunderstandings or confusion and approach any employees, agents, and/or representatives of Logan Square Tattoo, should such questions or concerns arise, prior to beginning Customer’s tattoo.By clicking here, I agree the above is true and correct. I acknowledge and understand the above paragraph.

Customer acknowledges that the obtaining of their tattoo is by his or her voluntary decision and deliberate choice and that Customer consents to the application of the tattoo and to any actions or conduct of employees, agents, and representatives of Logan Square Tattoo reasonably necessary to perform the tattoo procedure.By clicking here, I agree the above is true and correct. I acknowledge and understand the above paragraph.

Customer agrees to release, indemnify, forever discharge and hold harmless Logan Square Tattoo and its agents, employees, contractors, officers, shareholders, and tattoo artist listed above for this procedure from any and all claims, damages, injury, cost and expense, or legal actions including but not limited to allergic reaction, infection, or communicable disease which said customer may suffer, incur, be put to, or pay or layout by reason arising from connected in any way with Customer’s tattoo or procedure and conduct used to apply his or her tattoo or the negligence of Logan Square Tattoo and their employees, agents, shareholders and representative, Gifford Kasen, and tattoo artist listed above for this procedure.By clicking here, I agree the above is true and correct. I acknowledge and understand the above paragraph.

Customer acknowledges all photos taken of the tattoo and customer become property of Logan Square Tattoo, and might be used for such purposes, including but not limited to, advertisements, promotional material, commercially related items and/or for placement on Logan Square Tattoo’s website or social media, as we are proud of the work we do.By clicking here, I agree the above is true and correct. I acknowledge and understand the above paragraph.

OTHER

By signing my name below, it serves as my signature for all intents and purposes. I further acknowledge that this is considered a legal and binding document. * Sign Full Name

Date of Consent (today's date)

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