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CONSENT
FORM

Artist: Tracy Laub
BAP-TA 10233142
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Do you have any of the following medical conditions?
I have been fully informed of the inherent risks associated with getting a tattoo. I fully understand that these risks, known and unknown, can lead to injury, including, but not limited to: redness/swelling, bleeding, infection, scarring, fainting, plasma leaking, tenderness, scabbing, difficulties in detecting melanoma, allergic reactions to tattoo pigment, latex gloves, bandaging and/or soap or aftercare. Having been informed of the potential risks associated with getting a tattoo, I still wish to proceed with the tattoo application and I freely accept and expressly assume any and all risks that may arise from my choice to be tattooed.
I understand and agree that variations in color and design may exist between the design selected by me and ultimately applied to my body. Color and lines may appear differently on skin. I also understand that over time, the colors and the clarity of my tattoo will fade due to unprotected exposure to the sun and the naturally occurring dispersion of pigment under the skin.
I agree that the artist and Silk Creek Tattoo have given me the full opportunity to ask any and all questions about the application of my tattoo and all my questions have been answered to my total satisfaction.
 The artist and Silk Creek Tattoo have given me instructions on the care of my tattoo while it's healing and I understand and will follow them. I acknowledge that it is possible that the tattoo can become infected, particularly if I do not follow the instructions given to me. If any touch-up work to the tattoo is needed due to my own negligence, I agree that the work will be done at my own expense.
I am not now and will not be under the influence of alcohol or drugs for the duration of my tattoo procedure and I voluntarily submit to being tattooed by the artist without duress or coercion.
I do not have any symptoms of cold or illness such as cough, fever, congestion, shortness of breath, gastric upsets, etc. Or if I do, by filling out this form I agree to also VERBALLY tell my artist about such conditions.
I do not have any skin conditions in the area of the tattoo (e.g. stretch marks, rashes, eczema, infection, psoriasis, moles, freckles, etc.) Or if I do, by filling out this form, I agree to VERBALLY tell my artist about such conditions. Some of these conditions may require us to move the tattoo placement.
I do not have diabetes, epilepsy, hemophilia or a heart condition, nor do I take blood-thinning medication. I do not have any other medical or skin condition that may interfere with the application or healing of the tattoo. I am not the recipient of an organ or bone marrow transplant - or, if I am, have taken the prescribed regimen of antibiotics that is required by my doctor in advance of any invasive procedure such as tattooing. I am not pregnant or nursing. I do not have a mental impairment that may affect my judgment in getting the tattoo.
Neither the artist nor Silk Creek Tattoo is responsible for the meaning or spelling of the symbol or text that I have provided.
A tattoo is a permanent change to my appearance and can only be removed by laser or surgical means, which can be disfiguring and/or costly, and which in all likelihood will not result in the restoration of my skin to its exact appearance before being tattooed.
I agree to let my artist and/or Silk Creek Tattoo use photographs of me or my tattoo for portfolio or advertising purposes.
I hereby declare that I am of legal age (and have provided valid proof of age) and am competent to sign this agreement and I understand parental consent does not apply towards tattoo contracts or procedures in the state of Oregon.
I acknowledge that I have been given adequate opportunity to read and understand this document, that it was not presented to me at the last minute and I understand that I am signing a legal contract waiving certain rights to recover against the artist and Silk Creek Tattoo.

Thank you!

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