In consideration of the warranty hereby given by the supplier Art Eternal that the quality of all implements and materials to be administered in the supply service, comply with all relevant statutory requirements, Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Full Name *Date of Birth *Please tick if anything listed below currently applies to you or if you suffer from any of the following *ImpetigoHeart DiseaseDermatitisTaking prescribed Anticoagulants/Blood ThinnersDiabetesHepatitis B or CAnxietyScar Tissue or Stretch Marks (in area to be tattooed)Nausea/VomitingHIV or AIDSPregnantLow Blood Pressure, Fainting or DizzinessEpilepsyMental IllnessBreast FeedingSkin conditions: Eczema, Psoriasis or WartsNone of the Above.Any other known medical conditions not listed that may affect the tattooing procedure? (Please enter details below): * Full are 4 Any known allergies (including Latex allergy)? (Please enter details below): *Have you received the COVID-19 injection within the last 4 weeks? *YesNoAre you using numbing cream for your tattoo? *YesNoWhich artist are you using? *Description of Tattoo & Location on Body *Your Address *Your Telephone Number *I hereby certify that *I agree with the terms listed belowI am 18 years of age or older I am fully aware of the irrversible nature of the service to be provided I do not suffer from any blood or skin disease or allergy or nervous complaint I will follow the aftercare recommendations provided I agree to indemnify and keep indemnified the supplier against all claims or proceedings in respect of any personal injury or damage arising out of, or as a result of, the supply of service.Submit Tattoo Disclaimer Piercing Disclaimer Aftercare Info Call US