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Consent form

Please complete this mandatory form in advance or complete it on site before the session.

Do you take blood thinners, anticoagulants, or medications that weaken your immune system?
Do you have any skin condition in the area to be tattooed that could interfere with the tattooing process, such as (but not limited to): eczema, psoriasis, acne, freckles, moles, sunburn, recent scar, or any other skin disorder?
Do you have any of the following medical conditions: diabetes, heart disease, seizures, blood disorders, hemophilia, or any other health issue?
  1. I certify that I am over 18 years old (ID required).

  2. At the time of the tattoo, I am not under the influence of drugs or alcohol.

  3. I am not pregnant and I am not breastfeeding.

  4. I understand that there is a risk of an allergic reaction and that there is no way for the artist to check if I am allergic to the ingredients of the ink used.

  5. I understand that if there is any doubt about my skin or medical condition, I may request written consent from my doctor to perform the tattoo.

  6. I also understand that I am required to reschedule my appointment in the event of illness, and I agree to wear a procedure mask if I present with obvious symptoms of respiratory virus or any other viral infection.

  7. I fully acknowledge that following tattoo aftercare procedures is my responsibility, and I am aware that failure to follow these procedures could result in the risk of infection. I agree to carefully follow all post-tattoo instructions provided by Atelier Noir et Or in order to minimize any potential danger to my health.

  8. If retouching or several sessions are necessary, I agree to the same conditions and undertake to inform the artist of any change in my state of health.

  9. I hereby declare that I fully release Marie-Claude Décarie-Amiot from any liability, including, but not limited to, any liability related to undesirable repercussions, complications, infections, allergic reactions, or any other side effects that may occur following the tattoo.

THANKS! We have received your form.

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