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Falling Angel Tattoos (Tattoo Consent Form)

Tattoo Consent Form
(Print Page, Fill It Out & Take It With You To FALLING ANGEL TATTOO)

656 Suffolk Avenue
Brentwood, N.Y. 11784
(631) 922-8078

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I,______________________________________________, D.O.B._______________________
have contracted with FALLING ANGEL TATTOO on the date below to tattoo the following part(s) of my body: ______________________________________________.
I understand that there are certain risks associated with having the above part of my body tattooed
I assume sole responsibility of those risks, and that should an infection devolope that medical attention may be necessary.
I understand & agree to follow the recommended after care given to me by the artist.
I agree not to hold FALLING ANGEL TATTOO &/or its employees, or any promoter or person(s) who provide space to FALLING ANGEL TATTOOS liable in any manner for any problems arising from having the above procedure performed.
I state that I am over the age of 18 and that I am not under the influence of any drugs &/or alcohol, and that I have informed FALLING ANGEL TATTOOS of any medical conditions that I may have:
Prescription Medication:______________________________,
Heart Condition:____________________________________,
Diabetes:__________________________________________,
Allergies to:________________________________________,
Communicable Diseases:______________________________,
Other:_____________________________________________

Signature:_____________________________________Date:____/____/____
Artist:_________________________________Amount: $ ___________.____

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