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Em Nicole Tattoos decorative

Consent Form

Em Nicole Tattoos LLC

Tattoo consent, release, and waiver

Client Information

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Emergency Contact

Procedure Consent

I hereby consent to receive a permanent tattoo from Em Nicole Tattoos LLC. I understand that tattooing is a process involving the insertion of pigment into the dermal layer of the skin using needles, resulting in a permanent alteration to my appearance.

Health & Medical Disclosure

Please check all that apply (or check None)

Acknowledgement of Risks

I I understand and acknowledge that:

  • Tattooing involves breaking the skin and may cause pain, bleeding, swelling, or scabbing.

  • Infection, scarring, allergic reactions, or ink rejection may occur even with proper care.

  • Tattoo results may fade or change over time due to skin type, placement, sun exposure, or healing.

  • No guarantee has been made regarding the final appearance or longevity of my tattoo.

  • Improper aftercare may affect healing and eligibility for touch-ups.

  • Tattoos are permanent, and removal or cover-ups can be costly and ineffective.

  • Photos of my tattoo may be taken for portfolio or marketing use unless I request otherwise.

  • Service may be refused due to health concerns, intoxication, hygiene, or inappropriate behavior.

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Today's Date
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Legal Consent & Liability Waiver

I confirm that:

  • I am at least 18 years old and legally able to consent.

  • I am not under the influence of alcohol, drugs, or impairing medications.

  • I have fully disclosed all relevant medical conditions and medications.

  • I understand and follow all aftercare instructions provided.


Alcohol & Substance Disclosure

I understand that alcohol or substance use before tattooing may increase bleeding, healing complications, or other risks.

Please Choose One
I have not consumed alcohol or recreational substances within the past 24 hours.
I have consumed alcohol or recreational substances and choose to proceed.

If I choose to proceed after alcohol or substance use, I accept full responsibility for any complications during or after the tattoo and release Em Nicole Tattoos LLC and the artist from all related liability.

I hereby release and hold harmless Em Nicole Tattoos LLC, its artist(s), employees, and affiliates from any liability arising from:

  • Failure to follow aftercare instructions

  • Undisclosed or pre-existing medical conditions

  • Allergic reactions or unforeseen side effects

  • Dissatisfaction with design, placement, size, or healing outcome

  • This waiver applies to today’s procedure and any future services provided by Em Nicole Tattoos LLC.

Third-Party Property Liability Release

I acknowledge that the property owner and any third-party entities associated with the building where Em Nicole Tattoos LLC operates are not responsible for tattoo services rendered. I release and hold them harmless from any claims related to my visit or procedure.

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Today's Date
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By signing above, I acknowledge that I have read, understood, and voluntarily agree to all terms of this consent and waiver.

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