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Arch Envy

I acknowledge that any information contributed by me is true, to the best of my knowledge, and that the present condition of the area that has been treated or will be treated is stated on this record. I fully understand that ARCH ENVY only provides Cosmetic Tattooing; there is no medical treatment involved.


I realize that with any beauty service, there may be risks which must be understood. I will be fully responsible for any and all results which may arise from these beauty services. I do hereby agree to hold ARCH ENVY free from any and all claims or suits for damage, for injuries or complications resulting from any beauty service provided by ARCH ENVY.


The nature and purpose of the beauty services, the risks involved, and the possibility of complications have been fully explained to me. I understand that no guarantee or assurance has been given by anyone as to the results that may be obtained.


By signing below, I acknowledge that I have read and understand the above and all of my questions have been answered. I consent to receive the above beauty services.

December 23, 2024

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Street Address *

City *

Province *

Postal Code *

ACKNOWLEDGEMENT: I acknowledge that any information contributed by me is true, to the best of my knowledge, and that the present condition of the area that has been treated or will be treated is stated on this record. I fully understand that ARCH ENVY only provides Cosmetic Tattooing services; there is no medical treatment involved. I realize that with any beauty service, there may be risks which must be understood. I will be fully responsible for any and all results which may arise from these beauty services. I do hereby agree to hold ARCH ENVY free from any and all claims or suits for damage, for injuries or complications resulting from any beauty service provided by ARCH ENVY. The nature and purpose of the beauty services, the risks involved, and the possibility of complications have been fully explained to me. I understand that no guarantee or assurance has been given by anyone as to the results that may be obtained. By signing below, I acknowledge that I have read and understand the above and all of my questions have been answered. I consent to receive the above beauty services. *
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Second Participant's Date of Birth*
Second Participant's Information

Street Address *

City *

Province *

Postal Code *

ACKNOWLEDGEMENT: I acknowledge that any information contributed by me is true, to the best of my knowledge, and that the present condition of the area that has been treated or will be treated is stated on this record. I fully understand that ARCH ENVY only provides Cosmetic Tattooing services; there is no medical treatment involved. I realize that with any beauty service, there may be risks which must be understood. I will be fully responsible for any and all results which may arise from these beauty services. I do hereby agree to hold ARCH ENVY free from any and all claims or suits for damage, for injuries or complications resulting from any beauty service provided by ARCH ENVY. The nature and purpose of the beauty services, the risks involved, and the possibility of complications have been fully explained to me. I understand that no guarantee or assurance has been given by anyone as to the results that may be obtained. By signing below, I acknowledge that I have read and understand the above and all of my questions have been answered. I consent to receive the above beauty services. *
Third Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Third Participant's Date of Birth*
Third Participant's Information

Street Address *

City *

Province *

Postal Code *

ACKNOWLEDGEMENT: I acknowledge that any information contributed by me is true, to the best of my knowledge, and that the present condition of the area that has been treated or will be treated is stated on this record. I fully understand that ARCH ENVY only provides Cosmetic Tattooing services; there is no medical treatment involved. I realize that with any beauty service, there may be risks which must be understood. I will be fully responsible for any and all results which may arise from these beauty services. I do hereby agree to hold ARCH ENVY free from any and all claims or suits for damage, for injuries or complications resulting from any beauty service provided by ARCH ENVY. The nature and purpose of the beauty services, the risks involved, and the possibility of complications have been fully explained to me. I understand that no guarantee or assurance has been given by anyone as to the results that may be obtained. By signing below, I acknowledge that I have read and understand the above and all of my questions have been answered. I consent to receive the above beauty services. *
Fourth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Street Address *

City *

Province *

Postal Code *

ACKNOWLEDGEMENT: I acknowledge that any information contributed by me is true, to the best of my knowledge, and that the present condition of the area that has been treated or will be treated is stated on this record. I fully understand that ARCH ENVY only provides Cosmetic Tattooing services; there is no medical treatment involved. I realize that with any beauty service, there may be risks which must be understood. I will be fully responsible for any and all results which may arise from these beauty services. I do hereby agree to hold ARCH ENVY free from any and all claims or suits for damage, for injuries or complications resulting from any beauty service provided by ARCH ENVY. The nature and purpose of the beauty services, the risks involved, and the possibility of complications have been fully explained to me. I understand that no guarantee or assurance has been given by anyone as to the results that may be obtained. By signing below, I acknowledge that I have read and understand the above and all of my questions have been answered. I consent to receive the above beauty services. *
Fifth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Street Address *

City *

Province *

Postal Code *

ACKNOWLEDGEMENT: I acknowledge that any information contributed by me is true, to the best of my knowledge, and that the present condition of the area that has been treated or will be treated is stated on this record. I fully understand that ARCH ENVY only provides Cosmetic Tattooing services; there is no medical treatment involved. I realize that with any beauty service, there may be risks which must be understood. I will be fully responsible for any and all results which may arise from these beauty services. I do hereby agree to hold ARCH ENVY free from any and all claims or suits for damage, for injuries or complications resulting from any beauty service provided by ARCH ENVY. The nature and purpose of the beauty services, the risks involved, and the possibility of complications have been fully explained to me. I understand that no guarantee or assurance has been given by anyone as to the results that may be obtained. By signing below, I acknowledge that I have read and understand the above and all of my questions have been answered. I consent to receive the above beauty services. *
Sixth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Street Address *

City *

Province *

Postal Code *

ACKNOWLEDGEMENT: I acknowledge that any information contributed by me is true, to the best of my knowledge, and that the present condition of the area that has been treated or will be treated is stated on this record. I fully understand that ARCH ENVY only provides Cosmetic Tattooing services; there is no medical treatment involved. I realize that with any beauty service, there may be risks which must be understood. I will be fully responsible for any and all results which may arise from these beauty services. I do hereby agree to hold ARCH ENVY free from any and all claims or suits for damage, for injuries or complications resulting from any beauty service provided by ARCH ENVY. The nature and purpose of the beauty services, the risks involved, and the possibility of complications have been fully explained to me. I understand that no guarantee or assurance has been given by anyone as to the results that may be obtained. By signing below, I acknowledge that I have read and understand the above and all of my questions have been answered. I consent to receive the above beauty services. *
Seventh Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Street Address *

City *

Province *

Postal Code *

ACKNOWLEDGEMENT: I acknowledge that any information contributed by me is true, to the best of my knowledge, and that the present condition of the area that has been treated or will be treated is stated on this record. I fully understand that ARCH ENVY only provides Cosmetic Tattooing services; there is no medical treatment involved. I realize that with any beauty service, there may be risks which must be understood. I will be fully responsible for any and all results which may arise from these beauty services. I do hereby agree to hold ARCH ENVY free from any and all claims or suits for damage, for injuries or complications resulting from any beauty service provided by ARCH ENVY. The nature and purpose of the beauty services, the risks involved, and the possibility of complications have been fully explained to me. I understand that no guarantee or assurance has been given by anyone as to the results that may be obtained. By signing below, I acknowledge that I have read and understand the above and all of my questions have been answered. I consent to receive the above beauty services. *
Eighth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Street Address *

City *

Province *

Postal Code *

ACKNOWLEDGEMENT: I acknowledge that any information contributed by me is true, to the best of my knowledge, and that the present condition of the area that has been treated or will be treated is stated on this record. I fully understand that ARCH ENVY only provides Cosmetic Tattooing services; there is no medical treatment involved. I realize that with any beauty service, there may be risks which must be understood. I will be fully responsible for any and all results which may arise from these beauty services. I do hereby agree to hold ARCH ENVY free from any and all claims or suits for damage, for injuries or complications resulting from any beauty service provided by ARCH ENVY. The nature and purpose of the beauty services, the risks involved, and the possibility of complications have been fully explained to me. I understand that no guarantee or assurance has been given by anyone as to the results that may be obtained. By signing below, I acknowledge that I have read and understand the above and all of my questions have been answered. I consent to receive the above beauty services. *
Ninth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Street Address *

City *

Province *

Postal Code *

ACKNOWLEDGEMENT: I acknowledge that any information contributed by me is true, to the best of my knowledge, and that the present condition of the area that has been treated or will be treated is stated on this record. I fully understand that ARCH ENVY only provides Cosmetic Tattooing services; there is no medical treatment involved. I realize that with any beauty service, there may be risks which must be understood. I will be fully responsible for any and all results which may arise from these beauty services. I do hereby agree to hold ARCH ENVY free from any and all claims or suits for damage, for injuries or complications resulting from any beauty service provided by ARCH ENVY. The nature and purpose of the beauty services, the risks involved, and the possibility of complications have been fully explained to me. I understand that no guarantee or assurance has been given by anyone as to the results that may be obtained. By signing below, I acknowledge that I have read and understand the above and all of my questions have been answered. I consent to receive the above beauty services. *
Tenth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Street Address *

City *

Province *

Postal Code *

ACKNOWLEDGEMENT: I acknowledge that any information contributed by me is true, to the best of my knowledge, and that the present condition of the area that has been treated or will be treated is stated on this record. I fully understand that ARCH ENVY only provides Cosmetic Tattooing services; there is no medical treatment involved. I realize that with any beauty service, there may be risks which must be understood. I will be fully responsible for any and all results which may arise from these beauty services. I do hereby agree to hold ARCH ENVY free from any and all claims or suits for damage, for injuries or complications resulting from any beauty service provided by ARCH ENVY. The nature and purpose of the beauty services, the risks involved, and the possibility of complications have been fully explained to me. I understand that no guarantee or assurance has been given by anyone as to the results that may be obtained. By signing below, I acknowledge that I have read and understand the above and all of my questions have been answered. I consent to receive the above beauty services. *
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
CLIENT PERSONAL RECORD AND MEDICAL HISTORY
Check all that apply:
AIDS (HIV)
Abnormal Heart Condition
Accutane
Accutane or Acne treatment
Alcoholism
Allergies to Latex
Allergies to Lidocaine
Bleeding Disorder
Bleeds Easily
Blood Thinners
Botox
Chemical Skin Peel
Chemotherapy / Radiation
Cold Sores / Shingles
Contact Lenses
Diabetes
Do you have old permanent makeup?
Heart Problems
Hemophilia
Hepatitis / Jaundice
Hepatitis A, B, C, D
Hypoglycemia
Iron Deficiency / Anemia
Keloid Scars
Oily Skin
Planning on having a surgical brow/face lift?
Pregnancy
Pregnant or Breastfeeding currently
Skin Disorder(s)
Tan by booth or salon
Tumors/Growths/Cysts

Please list any current medications: *
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*

Middle Name

Last Name*

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

Street Address *

City *

Province *

Postal Code *

ACKNOWLEDGEMENT: I acknowledge that any information contributed by me is true, to the best of my knowledge, and that the present condition of the area that has been treated or will be treated is stated on this record. I fully understand that ARCH ENVY only provides Cosmetic Tattooing services; there is no medical treatment involved. I realize that with any beauty service, there may be risks which must be understood. I will be fully responsible for any and all results which may arise from these beauty services. I do hereby agree to hold ARCH ENVY free from any and all claims or suits for damage, for injuries or complications resulting from any beauty service provided by ARCH ENVY. The nature and purpose of the beauty services, the risks involved, and the possibility of complications have been fully explained to me. I understand that no guarantee or assurance has been given by anyone as to the results that may be obtained. By signing below, I acknowledge that I have read and understand the above and all of my questions have been answered. I consent to receive the above beauty services. *
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.


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