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Consent & health

Ready for your appointment.

Please fill in the whole form. Your artist enters the studio code at the end.

Personal details

Format: DD/MM/YYYY

Sex

Address and contact

Service

Service date
Service
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Artist

Health

Are you HIV positive?
Are you under the influence of alcohol or drugs?
Have you been free of hepatitis (jaundice) for a year?
Are you free of any heart condition, haemophilia (blood disorder) or epilepsy?
To my knowledge I have no other condition not named above that a tattoo could affect, directly or indirectly.
Allergies (e.g. latex)?

Consent

I accept the of Los Hermanos Ink
Yes, send me news and offers from Los Hermanos Ink by email. You can unsubscribe at any time.
Signature
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Filled in by the studio