TATTOO CONSENT FORM Tattoo Consent Form HYGIENE & SAFETY STANDARDS: Viaticum Gallery guarantees that all equipment, gloves, needles, and materials used for your tattoo procedure are sterile and single-use where applicable, and that strict hygiene, decontamination, and sterilization protocols are followed.All tattooing equipment is prepared and handled in accordance with industry standards. Our autoclaves are tested regularly, and the studio is inspected and verified by the local health department.All inks, pigments, and materials used during tattoo procedures comply with applicable EU regulations and safety standards. DESIGN * LOCATION * CONSENT - A * I hereby give persons representing Viaticum Gallery AS permission to perform the above stated procedure. I understand that tattoo is being performed under the recommended conditions, using equipment and techniques that comply with all the relevant statutory requirements. Viaticum Gallery AS and the self-employed artists residing within are certified by the local environmental health agency to perform tattoos. CONSENT - B * I have/will check the design for accuracy and colours being used and will confirm to the artist that I am happy with the stencil before the procedure takes place. I indemnify Viaticum Gallery AS and the artist from any errors within the design if found after consent and commencement of the tattoo. The treatment is permanent and cannot be removed or refunded if consent has been given. CONSENT - C * I confirm that I have received written information regarding aftercare (bottom of the page) and agree to follow the aftercare procedures recommended by the studio and artist until the tattoo is fully healed. I understand that local or general infection can and may occur due to unclean conditions outside of the studio. I understand that allergies to the ink may occur which can cause infection, affect the healing and the end result of the tattoo. I understand that scabbing will occur as a result of the tattoo and as advised I will protect this wound from any exposure to sun, dirt, prolonged water submersion, public bathing areas and any conditions that may affect or harm the tattoo. I understand that there may be scarring as a result of this tattoo. If I become aware of any potential problem, I agree to contact the studio/artist and/or my doctor immediately for advice. I agree to indemnify and keep indemnified Viaticum Gallery AS against all claims or proceedings in respect of any personal injury or damage arising out of, or as a result of this tattoo. HEALTH CONDITIONS: Please indicate below if you currently have or think you may have any of the following conditions that may affect the treatment: Blood Disorder * Yes No Blood disorders may increase the risk of excessive bleeding and affect healing during tattooing. Allergies * Yes No Certain allergies may increase the risk of ink reactions during or after tattooing. Infectious disease * Yes No Infectious diseases may require additional precautions to ensure client and staff safety. Skin Disorder * Yes No Skin disorders may affect healing and increase the risk of irritation or complications following tattooing. Keloids * Yes No A tendency to form keloid scars may increase the risk of excessive scarring following tattooing. Isotretinoin * Yes No It is recommended to wait at least six months after discontinuing this type of medication, as it may increase scarring and/or prolong/prevent healing. Fainting * Yes No Clients with a history of fainting may be at increased risk during tattooing. Epilepsy * Yes No Epilepsy may increase the risk of seizures during tattooing, particularly if the condition is not well controlled. Pregnancy * Yes No Tattooing is not performed during pregnancy due to increased medical risk and potential complications. Diabetes * Yes No Diabetes may affect circulation and wound healing, increasing the risk of infection and delayed recovery. I have eaten * Yes No Not eating prior to tattooing may increase the risk of fainting, dizziness, or discomfort. Drugs/Alcohol (24hrs prior) * Yes No Use of drugs or alcohol within 24 hours prior to tattooing may increase the risk of bleeding, fainting, and complications. Any medication / condition that may be of concern * Yes No Do you have bleeding disorders, heart disease, any other relevant health conditions or taking blood-thinning medication? Mention Details * CONSENT - D * I confirm that I am eighteen (18) years of age or over and will provide ID if requested by the studio. I confirm that I have had sufficient time to read and understood this form and agree to be legally bound by it. I do this of my own free will and hereby declare that I am not under the influence of alcohol, drugs, or medications that could impair my judgment.Viaticum Gallery AS reserve the right to refuse performing the procedure if there is concern with any of the stated details for the matter of health and hygiene. FULL NAME * EMAIL * DATE OF BIRTH * TODAY'S DATE * Signature * Clear ID Provided * Yes No ID / Passport Number * Upload ID Drop a file here or click to upload Choose File Maximum file size: 20MB Where did you hear about us? * Facebook Instagram Google TikTok Friend Other Follow us on Instagram & TikTok for discounts & offers Facebook: @ViaticumGallery Instagram: @ViaticumGallery TikTok: @viaticumtattoogallery AFTERCARE: Keep your tattoo clean throughout the healing period. Leave the protective covering applied by your artist in place for at least 3–4 hours, or longer if advised. Once removed, gently wash the area with lukewarm water and a mild, fragrance-free cleanser to remove excess ink and plasma. Pat dry with a clean paper towel—do not rub and do not cover it again with plastic wrap, let the area breathe.Apply a thin layer of the aftercare product recommended by your artist. Do not over-apply. Repeat cleansing and moisturizing 2–3 times daily for approximately 4–6 weeks, keeping the tattoo clean and lightly moisturized at all times.Avoid soaking, swimming, direct sun exposure, and friction during healing. Do not pick or scratch the tattoo.Full, detailed aftercare instructions are available on our website – Click Here. NOTE: Retain this form for your reference and present it for any after care support you may require. Aftercare, including ink re-touch up that may be needed as a result of natural healing within six weeks, will be free of charge on presentation of this form. Any support required as a result of incorrect aftercare, with a different artist or without this form will be chargeable.You can talk with one of us in private if you want.If any provision, section, subsection, clause or phrase of this release is found to be unenforceable or invalid, that portion shall be severed from this contract. The remainder of this contract will then be construed as though the unenforceable portion had never been contained in this document. Price * Artist * SelectAnkoVeronicaAndreeaFreyaTanouVeraLucy Aftercare Product * Yes No Supports proper healing and helps reduce the risk of irritation or infection. Are you interested in Viaticum giveaways, events , gifts? * Yes No Submit Consent If you are human, leave this field blank. Δ
