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CONSENT


I hereby consent to Artists, Employees, guest Artists or Agents of Nocturna Tattoo to perform a Tattoo and/or body piercing. I agree that I have given the full oppurtunity to ask any questions I might have about tattoos and/or body piercings I do hereby acknowledge and agree to the following:


DEPOSIT POLICY

Deposits are up to the discretion of the individual artist. Deposits are non-refundable. Deposits are credited toward the final costs of a tattoo or body piercing. Any cancellation, no-show or failure to provide of reschedule, will forfeit the deposit.


ACKNOWLEDGEMENT OF RISK

Nocturna Tattoo takes all reasonable precautions for your safety. This includes observing commonly acknowledged and appropriate standards techniques, instruments, pigments, and jewelry. Nocturna Tattoo cannot guarantee against risks associated with performing Tattoos, piercings and body modifications.


I understand that the performance of creating a Tattoo is art. It is a creative process and can and often does vary from time to time. I assume the risk that the final product may vary in some minor ways from expectation. I accept this risk and consent to allow Artists, Employees, guest Artists or Agents of Nocturna Tattoo to perform the Tattoo and/or body piercing. I also understand that the performance of creating a Tattoo and/or body piercing is an invasive procedure. Despite all reasonable precautions for sanitization and safety, it may still result in medical complications, including but not limited to: infection, disease, pain, swelling, and scarring. Such complications may contribute to, or cause serious medical conditions. To the extent provided by Utah law, I hereby hold harmless and indemnify Artists, Employees, guest Artists or Agents of Nocturna Tattoo from any and all causes of actions arising from physical harm caused by their acts and omissions. 

NO MEDICAL ADVICE

I understand that Artists, Employees, guest Artists or Agents of Nocturna Tattoo are not medical professionals. Any suggestion or advice from Artists, Employees, guest Artists or Agents of Nocturna Tattoo are those made by artists and not medical advice. 


CLIENT RESPONSIBILITY FOR AFTERCARE

Aftercare instructions will be given by Artists, Employees, guest Artists or Agents of Nocturna Tattoo. Strict adherence to this advice is required to ensure the quality of any work, as well as to protect against known health risks. Length of healing process for each piercing varies and will be discussed at time of appointment.

Client acknowledges that client is solely responsible for following these instructions. Client also acknowledges that I must exercise my own proper aftercare of any Tattoo, piercings and body modifications. Healing takes several weeks. Client acknowledges client will provide for three to four weeks of aftercare to allow for proper healing. And client takes all responsibilities to contact Nocturna Tattoo for any questions in relation to healing concerns, questions or processes.

 

PERMANENT CHANGES

Client also acknowledges that changes to the body are permanent. There may not be any reversal of certain services and Artists, Employees, guest Artists or Agents of Nocturna Tattoo have not expressed or implied that they are reversible.


TOUCH UP & CORRECTIONS

Nocturna Tattoo provides for one free touch up session within 2-3 months of receiving any Tattoo. After that time, any touch up or corrective work will be charged. Client acknowledges that improper aftercare may affect the quality of work performed by Artists, Employees, guest Artists or Agents of Nocturna Tattoo. Client takes responsibility to timely contact Artists, Employees, guest Artists or Agents of Nocturna Tattoo with concerns regarding touch up work.


MINOR PIERCING

I acknowledge that obtaining this piercing is my child's choice alone and will result in a permanent change to his/her/their appearance, and that no representation has been made toe me as to the ability to later restore the skin involved in this perfecting ate its pre piercing condition.

I Agree

December 22, 2024

Please select who will be getting pierced
AdultMinor
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First Client Name

First Name*

Last Name*

Phone*
First Client Date of Birth*
First Client Information

Preferred pronouns (optional)
First Client Signature*
Client Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
Minor ID type & number

ID type

ID number
*Answering Yes to any of the questions does not necessarily prelude the person from receiving a tattoo, body piercing/modification please check one. Parent/Guardian answer to the best of your knowledge the questions for a minor.
Has a physician told you that you have hepatitis?
Yes
No
Have you been diagnosed with jaundice space (yellowing of the skin and eyes) in the last 10 days?
No
Yes
Are you prone to any fainting or lightheadedness?
No
Yes
Do you have diabetes?
No
Yes
Do you have any difficulty stopping bleeding?
No
Yes
Do you take any blood thinners?
No
Yes
Do you have any heart related problems?
No
Yes
Do you have high blood pressure?
No
Yes
Have you taken any drugs or had any alcoholic beverages in the last 8 Hours?
No
Yes
Have you consumed food within the last two hours?
No
Yes
Have you consumed any anticoagulants in the last 24 hours? (Aspirin, Advil, Motrin, Ibuprofen, Aleve)
No
Yes
Are you pregnant?
No
Yes
Do you have any other conditions that may affect the healing of this tattoo/body piercing?
No
Yes

If so, please state in box
Do you have any known allergies?
No
Yes

If so, please list allergies
Do you have hemophilia?
Click to customize question*
No
Yes
Do you have any skin conditions? Such as keloid or hypertrophic scarring, or psoriasis?
Click to customize question*
No
Yes
Type of Piercing

Type of piercing *
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Preferred pronouns (optional)
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary. I have read this release form and confirm that all the information I have given is correct. I understand this is a release form and I agreed to be legally bound to it. I certify that I am over the 18 years of age. Unless I have consent with a legal guardian or parent on this form.


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