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Sojourn Tattoo

119 S 9th St Tacoma, WA 98402

253-272-2922 www.sojourntattoo.com



Customer Release

By signing below, I acknowledge the following to be true:

I acknowledge that I am over the age of eighteen.

I Agree

I acknowledge that I am not pregnant.

I Agree

I acknowledge that a tattoo is permanent, and obtaining a tattoo is by choice and I consent to the application of the tattoo. 

I Agree

I acknowledge that my artist is not responsible for any misspelling or meaning of any script and/or symbol and I confirm that I agree to final placement and design of any tattoo on my body. 

I Agree

I acknowledge that variations in color and design may exist between any tattoo represented on paper selected by me and what is ultimately applied to my body. 

I Agree

I acknowledge that I am not under the influence of drugs or alcohol or any other intoxicating substances. 

I Agree

I acknowledge that it is not reasonably possible for my artist to determine whether I might have an allergic reaction to the pigment used in my tattoo. I agree to accept the risk that such a reaction is possible. 

I Agree

I acknowledge that infection is always possible and I recognize that the responsibility for properly healing my tattoo is entirely my own. 

I Agree

I agree to follow all directions contained in the aftercare (written copies are available upon request.) 

I Agree

I acknowledge that I have been informed that in the event of medical complications I should seek medical advice following a consultation with my artist. 

I Agree

I hereby acknowledge my artist’s copyright of their artwork and grant permission to publish photographic portraits of the tattoo or pictures of me, or reproductions of the tattoo in any form deemed appropriate such as media art and advertising. I waive any rights i may have to inspect or approve the finished product or the use of its content. 

I Agree

I agree to release my artist and the studio in which my tattoo was applied from any claims, damages, or legal actions, arising from designing and/or applying my tattoo. I am, and have been, satisfied with the services provided to me. 

I Agree

December 19, 2024

Covid-19 Survey
Symptoms of COVID-19 include: • Fever • Fatigue • Dry Cough • Difficulty Breathing I agree to the following: • I understand the above symptoms and affirm that I, as well as all household members, do not currently have, nor have experienced the symptoms listed above within the last 14 days. • I affirm that I, as well as all household members, have not been diagnosed with COVID-19 within the past 10 days. • I affirm that I, as well as all household members, have not knowingly been exposed to anyone diagnosed with COVID-19 within the past 10 days. • I affirm that I, as well as all household members, have not traveled outside of the country or to any city considered to be a “hot spot” for COVID-19 infections within the past 10-days. • I understand that Sojourn Tattoo cannot be held liable for any exposure to the COVID-19 virus caused by misinformation on this form or the health history provided by each client. *
Agree
Do not Agree
Additional Information

Artist Name: *

Please write a brief description of the tattoo and any lettering you will be receiving *
First Participant's Name

First Name*

Middle Name

Last Name*

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

Medical History

Please inform your artist of any medical or skin conditions that you may have.

Please Note: We are unable to apply tattoos on pregnant people.


Do you have any allergies? Including known allergies to specific tattoo ink

Do you now or have you ever had any communicable disease or infections?

If you have hepatitis or are HIV positive and don’t wish to state so on this form, please inform your artist verbally.

This information is strictly confidential. All information provided helps to insure the safety of you and your artist.
THANK YOU

First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

Medical History

Please inform your artist of any medical or skin conditions that you may have.

Please Note: We are unable to apply tattoos on pregnant people.


Do you have any allergies? Including known allergies to specific tattoo ink

Do you now or have you ever had any communicable disease or infections?

If you have hepatitis or are HIV positive and don’t wish to state so on this form, please inform your artist verbally.

This information is strictly confidential. All information provided helps to insure the safety of you and your artist.
THANK YOU

Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

Medical History

Please inform your artist of any medical or skin conditions that you may have.

Please Note: We are unable to apply tattoos on pregnant people.


Do you have any allergies? Including known allergies to specific tattoo ink

Do you now or have you ever had any communicable disease or infections?

If you have hepatitis or are HIV positive and don’t wish to state so on this form, please inform your artist verbally.

This information is strictly confidential. All information provided helps to insure the safety of you and your artist.
THANK YOU

Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Medical History

Please inform your artist of any medical or skin conditions that you may have.

Please Note: We are unable to apply tattoos on pregnant people.


Do you have any allergies? Including known allergies to specific tattoo ink

Do you now or have you ever had any communicable disease or infections?

If you have hepatitis or are HIV positive and don’t wish to state so on this form, please inform your artist verbally.

This information is strictly confidential. All information provided helps to insure the safety of you and your artist.
THANK YOU

Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Medical History

Please inform your artist of any medical or skin conditions that you may have.

Please Note: We are unable to apply tattoos on pregnant people.


Do you have any allergies? Including known allergies to specific tattoo ink

Do you now or have you ever had any communicable disease or infections?

If you have hepatitis or are HIV positive and don’t wish to state so on this form, please inform your artist verbally.

This information is strictly confidential. All information provided helps to insure the safety of you and your artist.
THANK YOU

Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Medical History

Please inform your artist of any medical or skin conditions that you may have.

Please Note: We are unable to apply tattoos on pregnant people.


Do you have any allergies? Including known allergies to specific tattoo ink

Do you now or have you ever had any communicable disease or infections?

If you have hepatitis or are HIV positive and don’t wish to state so on this form, please inform your artist verbally.

This information is strictly confidential. All information provided helps to insure the safety of you and your artist.
THANK YOU

Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Medical History

Please inform your artist of any medical or skin conditions that you may have.

Please Note: We are unable to apply tattoos on pregnant people.


Do you have any allergies? Including known allergies to specific tattoo ink

Do you now or have you ever had any communicable disease or infections?

If you have hepatitis or are HIV positive and don’t wish to state so on this form, please inform your artist verbally.

This information is strictly confidential. All information provided helps to insure the safety of you and your artist.
THANK YOU

Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Medical History

Please inform your artist of any medical or skin conditions that you may have.

Please Note: We are unable to apply tattoos on pregnant people.


Do you have any allergies? Including known allergies to specific tattoo ink

Do you now or have you ever had any communicable disease or infections?

If you have hepatitis or are HIV positive and don’t wish to state so on this form, please inform your artist verbally.

This information is strictly confidential. All information provided helps to insure the safety of you and your artist.
THANK YOU

Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Medical History

Please inform your artist of any medical or skin conditions that you may have.

Please Note: We are unable to apply tattoos on pregnant people.


Do you have any allergies? Including known allergies to specific tattoo ink

Do you now or have you ever had any communicable disease or infections?

If you have hepatitis or are HIV positive and don’t wish to state so on this form, please inform your artist verbally.

This information is strictly confidential. All information provided helps to insure the safety of you and your artist.
THANK YOU

Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Medical History

Please inform your artist of any medical or skin conditions that you may have.

Please Note: We are unable to apply tattoos on pregnant people.


Do you have any allergies? Including known allergies to specific tattoo ink

Do you now or have you ever had any communicable disease or infections?

If you have hepatitis or are HIV positive and don’t wish to state so on this form, please inform your artist verbally.

This information is strictly confidential. All information provided helps to insure the safety of you and your artist.
THANK YOU

Parent or Guardian's Email Address

Email*

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

Driver's license/State ID # *
  
Upload a photo of your drivers license or government issued ID *
Valid file types: JPG, GIF, PNG, and PDF
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

Medical History

Please inform your artist of any medical or skin conditions that you may have.

Please Note: We are unable to apply tattoos on pregnant people.


Do you have any allergies? Including known allergies to specific tattoo ink

Do you now or have you ever had any communicable disease or infections?

If you have hepatitis or are HIV positive and don’t wish to state so on this form, please inform your artist verbally.

This information is strictly confidential. All information provided helps to insure the safety of you and your artist.
THANK YOU

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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