Tattoo Pre-check

Pre-Tattoo Consent & Health Check

This form is used to review your basic information and health condition before the tattoo session. Please complete the fields and check the relevant items.

Client Information & Health Status

Health Screening Questions *

1. Have you consumed alcohol within the last 24 hours? *
Alcohol may affect bleeding and physical condition during tattooing.
2. Have you taken any medication or experienced poor physical condition within the last 24 hours? *
This helps us understand whether your recent condition may affect today's session.
(e.g. fever, dizziness, sleep deprivation, dehydration, fatigue)
3. Have you had enough food and water today? *
This helps reduce the chance of dizziness or weakness during the procedure.
4. Do you currently have a fever, signs of infection, skin inflammation, wounds, or rash? *
This checks for current symptoms that may make tattooing unsafe today.
5. Are you taking blood thinners or any prescribed medication? *
This may directly affect bleeding and how the session should be handled.
6. Are you currently taking any medication? *
Medication may affect bleeding, healing, inflammation, or skin response.
(e.g. blood thinners, aspirin, steroids, antibiotics, acne medication, immunosuppressants)
7. Are you currently pregnant, possibly pregnant, or breastfeeding? *
This helps us review hormone-related and recovery considerations before the session.
8. Are you currently being treated for any medical condition? *
Your current health condition may affect whether the tattoo session can proceed safely.
(e.g. heart disease, high blood pressure, diabetes, liver/kidney/thyroid disease, immune-related conditions)
9. Have you recently had any skin treatment or procedure on the area to be tattooed? *
This helps us assess the current condition of the skin in the tattoo area.
(e.g. laser treatment, peeling, resurfacing, steroid injection, mole removal)
10. Do you have any allergies to metals, latex, disinfectants, adhesives, or tattoo pigments/inks? *
This checks for possible allergic reactions to materials used during the procedure.
11. Do you have a history of skin conditions, keloids, hypersensitivity, or delayed wound healing? *
This helps us understand how your skin may react and recover.
12. Do you have any blood-related or infectious conditions? *
This helps us assess bleeding risk and hygiene-related precautions.
(e.g. hemophilia, anemia, bleeding disorder, hepatitis B/C, HIV, etc.)
13. Have you ever had an adverse reaction after a tattoo or piercing? *
This checks whether you have had unusual reactions during past body art procedures.
(e.g. severe swelling, rash, infection, excessive bleeding, fainting)
14. Do you tend to feel faint easily, or have you ever fainted during needles, pain, or procedures? *
This is to help manage your safety and physical condition during the session.
15. Is there any other health information you think we should know before your tattoo appointment? *
Please share anything important that was not covered in the questions above.

Client Confirmation & Consent *

Client Signature *

Please sign directly in the box below using your finger or mouse.

Date: 2026-04-28