TATTOO CONSENT FORM Name * First Name Last Name Email * Phone * (###) ### #### Date of Birth * MM DD YYYY Address Address 1 Address 2 City State/Province Zip/Postal Code Country Tattoo Placement Date of Tattoo * MM DD YYYY Batch numbers of Ink * Medical History Practitioner * Joe Michelle * By ticking this box I acknowledge that the information stated above is correct and truthful and that I (the above named person) am over the age of 18 and do hereby give full consent to have my body tattooed by Impermanence Tatu practitioners. I am fully aware of the process involved and I understand the importance of adhering strictly to the correct aftercare procedure which is outlined thoroughly in the “aftercare” section of this website. I understand that if this aftercare advice is not correctly adhered too that infection can happen and if this becomes the case that it could not be the fault of Impermanence Tatu practitioners. Thank you!
