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Rebel Hearts Consent Form

Please Complete this on the day of your tattoo booking before you arrive at the studio

DATA PROTECTION: The information you provide us will not be shared with third parties, it will be stored in a secure place and will be destroyed in compliance with data protection laws

Do you have ID
Yes
No

Medical History

Please tick if you have any of the following
Are you currently on medication
Yes
No
Do you suffer from any other health issues, including mental health? This is so we can understand your needs and to make sure you feel supported and safe, this information is not mandatory, but the right support can means a better quality of work and a be
Yes
No
Are you neurodivergent? This is so we can understand your needs and to make sure you feel supported and safe. This information is not mandatory, but the right support can mean a better quality of work and a better experience for both parties
Yes
No
Are you under the influence of drugs and/or alcohol
Yes
No
Are you pregnant or breastfeeding?
Yes
No
Are you Vegan?
Yes
No

Disclaimer


No tattoo is 100% perfect, but we will always do our best to meet your expectation. All skin is different, and this can be reflected in the healing process, especially on hands, fingers and feet. One touch up in these areas will be free, subsequent touch ups will be full process. By signing below you are giving us permission to share your tattoo and possibly your presence in the studio on our social media. We also have CCTV in the studio, please ask about this if this is an issue

I hereby declare I am of legal age (18) and I am competent to sign this agreement or if not my parent or legal guardian should sign on my behalf, and that parent or guardian is in complete understanding and concurrence with this agreement. I also understand that each tattooist that operates from The Rebel Hearts Tattoo Club premises represents themselves only as an individual sole trader & is self employed.

Date of birth
Date
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