Tattoo Consent Form Please review this consent document in its entirety prior to signing and completing. If you are unable to complete the form below, reach out through the contact page for a fillable PDF. Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.1General Demographics2General Health3Design4Consents5Final step - sign Consent Form Name, as it appears on your ID: *FirstLastDate of Birth *PhoneEmail *Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhoto ID * Click or drag a file to this area to upload. NextSelect any and all of the following conditions or medication classes that you are currently experiencing or taking (select "N/A" if none apply): * Medical *DiabetesEczema, psoriasis, or sunburnFreckles, acne, or molesPregnant or nursingLatex or other allergyTaking blood thinners*Experiencing COVID-19 symptoms**Have any type of infection or rashTaking antibioticsExperiencing flu/respiratory symptomsN/A, none of these*Examples of these medications include Coumadin, Eliquis, Pradaxa, Lixiana, Xarelto, etc. **Fever, chills, cough, loss of taste or smell, vomiting or nausea, congestion, runny nose, etc. Emergency Contact *FirstLastPhone *PreviousNextPlease provide a brief description of the tattoo and location on your body for the piece.  Be as specific as possible (e.g. include design ideas, location, size, colors, etc. if able): * * on it If your design contains any names, numbers or letters, type out the information below CAREFULLY. You can also provide details such as font preferences as well. DOUBLE CHECK YOUR SPELLING, this is permanent!: textIf you have photos of something you wanted, have drawn, references, or anything that may help in the creation of your design, you can upload them here: Reference photos Click or drag files to this area to upload. You can upload up to 3 files. PreviousNextPlease review and acknowledge the following items by initialing where appropriate. In consideration of receiving a tattoo from Joshua Stafford (hereinafter referred to as "the artist"), I agree to the following: 1. *I acknowledge I am not under the influence of alcohol or drugs. I give my consent to the application of the tattoo and to any actions of the artist reasonably necessary to perform the tattoo process. If I have any condition that might affect the healing of this tattoo, I will inform the artist before the tattoo process is started. I am not pregnant or nursing. I acknowledge that infection is always possible as a result of the obtaining of a tattoo, particularly in the event that I do not take proper care of my tattoo. Other possible risks include possible allergic reactions to tattoo pigments, latex, and/or soaps, scarring, and challenges in detecting melanoma. I have received aftercare instructions from the artist, and I agree to follow them while my tattoo is healing. I agree that any touch-up work needed due to my own negligence in this matter will be done at my own expense. 2. *I realize that variations in color and design may exist between any tattoos selected by me and as ultimately applied to my body. I understand that if my skin is dark, the colors may not appear as bright as they do on lighter skin. I understand that if I have skin treatments, laser hair removal, plastic surgery, or any other skin altering procedures, it may result in adverse changes to my tattoo. I acknowledge that a tattoo is a permanent challenge to result in adverse changes to my tattoo. I acknowledge that a tattoo is a permanent change to my appearance and that no representations have been made to me as to the ability to change or remove my tattoo. 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. 3.(*Only required if your design has letters and/or numbers) I have reviewed the spelling of the tattoo I am requesting containing lettering and/or numbers. I have verified that this is how it will appear in my tattoo. I acknowledge that the artist will not be held responsible for any spelling mistakes made by you (the client). The sections above are for you (the client) to share the correct information with the artist. If your tattoo contains lettering or dates/numbers written in another language that you are not familiar with, the artist may not be either. Please double check what you would like as this is permanent! After that, please initial! 4. *I agree that the artist follows a NO REFUND policy for tattoos following completion and I will not request a refund for any reason whatsoever. I understand that the artist is an individual artist and is not affiliated with any shop, location, or practicing under an artist at a licensed shop. I waive and release, to the fullest extent allowed by law, the artist from all liability to any claims or causes of action for personal injury or other damages resulting from negligence or failure to follow the guidelines outlined herein. I understand that a tattoo represents a permanent alteration to my appearance and can only be removed through laser or surgical procedures which may result in scarring, be costly, and likely not restore my skin to its exact pre-tattoo condition. I agree to reimburse the artist for any legal fees and costs incurred in any action that I initiate against the artist in which the artist is found to be the prevailing party. 5. *I acknowledge that I have reviewed the aftercare section on the artisticspektrum.online webpage, and understand the requirements to safely maintain a tattoo through the healing process. 6.(Optional) I give the artist the right to use my likeness in photographs on their website, via networking sites such as Instagram, Bluesky, Tiktok, and Youtube. I also give my consent for the artist to use my likeness as well as any/all tattooed area(s) to be available in printed materials, portfolio books, and advertisements as appropriate. I will take no monetary or claim against the artist for the use of photographs taken throughout or after my tattoo procedure. I have not falsely represented myself in any way to the artist. PreviousNextThis form allows you to place a deposit down for your piece if you are interested in securing an appointment. At least $50 must be placed prior to appointment confirmation. This can be done outside of this form. Please contact for alternative ways to provide a deposit. DepositCredit Card field is disabled, Square payments are not enabled in the form settings.I, *FirstLastby digitally signing and submitting this agreement, acknowledge that I have been given the full opportunity to ask any and all questions which I might have about the obtaining of a tattoo and that all of my questions have been answered to my full satisfaction. I have agreed to any and all preventative guidelines and requirements that the artist requires of me. I specifically acknowledge that I have been advised of the facts and matters as set forth and acknowledged above. I hereby affirm that I am of legal age and have provided valid proof of age and identification, and am competent and of sound mind to sign this agreement. Date *Signature * Clear Signature PreviousSubmit Like this:Like Loading...