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CONTACT
Consent Form
Touched by the Arts Tattoo Studios
Consent Form
First name
*
Last name
*
Birthday
*
Month
Phone
*
Email
Procedure Date
*
Month
Description and Location on the Body where the Tattoo will be done.
*
Are you under the influence of drugs or alcohol?
*
FEMALE ONLY: Are you pregnant or nursing?
Do you have a communicable disease?
*
Do you have any skin conditions?
*
Skin conditions (e.g. Rashes, eczema, infection, psoriasis, freckles, etc.)
If yes, please identify the condition.
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