Required Appointment Preparation & Policy Acknowledgement

⚠️ IMPORTANT — PLEASE READ BEFORE PROCEEDING

This is not a routine intake form. This checklist contains important appointment policies, preparation requirements, and consent acknowledgements. A waiver will be completed prior to tattooing begins

Your responses confirm that you understand and agree to these requirements.

Failure to review this form carefully may result in:

• Delays or changes to your appointment
• Rescheduling if preparation requirements are not met
• Loss of your booking fee where applicable

This form is part of your appointment preparation. Completion without reading does not waive these policies.

Please read each section carefully and check each box yourself.

THIS IS NOT THE WAIVER! You will fill that out at your apt! PLEASE READ CAREFULLY should you fail to follow the requests below- it is my. Option to refuse service- and forfeit your deposit

Name *

First

Last

Email *

Appointment Time Reminder- check all

• My scheduled appointment time is my arrival time
• I agree to arrive on time and ready
• I understand that arriving late may result in: • Rescheduling of my appointment • Loss of my booking fee
• A waiver will be filled out at my appointment
• I am aware- the address/location is – 115 rands rd, ajax-
• On Street parking is available-either rands rd, or swanston cres Do not park in the driveway

Illness checklist/screening – if you have started with any of these in the last 3-5 days and have not already rescheduled- your apt will be cancelled and deposit forfeit

• New cough
• Shortness of breath-not asthma related
• Difficulty swallowing
• Decrease/loss of taste/smell
• Pink eye
• Fever -higher than 37.8 C or 100F
• Sore throat-not related to allergies or other medical conditions you normally have
• Runny or stuffy nose- not related to allergies
• Nausea,vomiting, diarrhea, stomach pain
• Unusual headache if your not prone.
• Extreme fatigue/tiredness
• a dr or health care provider told you that you should be isolating?
• You have travelled outside of Canada in the last 14 days?
• You have a sunburn, cut, rash within a handsize around the tattoo area- we will need to reschedule
• you have been identified as been in contact with someone who currently has covid-19
• You have any medical conditions that could affect the tattoo proceedure or healing of your tattoo
• I’m currently taking antibiotics – or finished within the last 14 days
• I have had or will have a surgical procedure within 4 weeks before or after this apt- it’s not recommended to get the tattoo if this is the case- it may impact healing of surgical procedure or your tattoo
• None of the above

if you are feeling unwell – even if you think it might just be a cold- to please reschedule your tattoo apt. For the safety of myself and others who may be attending my studio

Design & placement confirmation – check all

• I have reviewed my tattoo design
• I am happy with the concept and direction
• I understand that digital mock-ups are a visual reference only
• 30 min is slotted for a pre-tattoo consultation to discuss your tattoo and any additional minor changes to the design-any time after that is billed time plus tattoo time @$150 per hour
• I understand that colors, tones, and fine details may appear different once tattooed on skin
• I understand that skin tone, texture, and healing process will affect the final result
• I understand and accept that the final tattoo may vary from the digital design
• I understand any final adjustments will be made at the start of my appointment
• I am clear on placement and approximate size of my tattoo
• If needed, minor adjustments will be completed before the tattoo begins
• I will review the stencil in person and speak up if any changes are needed before we begin
• And I understand that I’m responsible for confirming all detail, details, placement size, and design prior to tattooing
• I understand that tattoos are handmade and not an exact replica of a digital image

Personal preparation – check all

• I am well rested
• I have eaten a good meal
• I am hydrated
• I am wearing comfortable clothes that I understand will possibly get ink on them, which does not wash out

What to bring – check all if you don’t have these- you will be refused your tattoo and any fees paid will be forfeited

• Water
• A sugary drink
• An additional sugary drink needed for emergency in case you have low blood sugar
• 1 to 2 snacks – granola bar, fruit, cheese/crackers, sandwiches are good options
• Headphones /music/entertainment
• Comfort items – blanket and pillow

and and placement

Additional – check all

• I have checked and have no cuts, wounds, or irritation in the tattoo area
• i understand that if my skin is not suitable on the day (sunburn, irritation, cuts, etc.), the appointment may be rescheduled and booking fee may be forfeited
• I have showered, exfoliated
• I have applied a moisture mask as requested – to do so apply a large amount of moisturizer to the tattoo area wrap it with plastic apply this minimum 30 minutes before arriving this helps soften your skin and make the tattoo a lot less abrasive
• I will be applying a numbing product as we have already discussed and have followed instructions provided
• I understand it can benefit some advil/tyleno 1 hr prior to apt and taken as instructed on package
• I have taken ALL prescription medication’s as directed by my physician
• I do smoke, and will bring nicotine alternatives, gum, patch, vape as breaks our limited to one and a half to two hours minimum

If you bring a guest or a plus one please check all

• you understand you may only guest with you only
• Guests are to remain in the studio area

Guest policy – is preferred to come alone guest could provide an unwanted distraction for both you and myself

Final acknowledgement – check all

• I understand this is a tattoo procedure, and I will communicate any questions or concerns before the tattoo begins
• I understand a tattoo is a wound- and infection is a big risk while it’s healing, and have made precautions to reduce risk – fresh bedding, paper towel supply and clean distilled water for cleaning
• I understand if I have concerns for a possible infection I’ll immediately seek medical care at a dr/clinic.
• I confirm I reviewed all sections above, and I am prepared for my appointment – if I have not and arrive without being prepared as this form indicates- I understand my apt is forfeited and I’ll be refused my tattoo.
• I understand that final healed results will vary from both fresh tattoos and digital preview- and could also reflect my aftercare- if it healed poorly and additional work is required to repair pigment loss – standard rates apply to fix
• I understand photos may be taken of my tattoo for documentation and/or portfolio purposes

Aftercare commitment – check all

• You have read and understand all aftercare instructions provided by email
• You’re prepared to properly care for your tattoo for a minimum of 30 days- results of healing will mark possible inadequate aftercare practices- how your tattoo heals is result of your care- it should heal and look the same as tattoo day- missing pigment etc and repairs to poor aftercare will be billed at the hourly rate- including damages from infections.
• A free touch up may be offered should an imperfection or as a result of missing data from the tattoo design as a result of anrtist application. Not poor healing

Please describe tattoo location You’re looking to have your tattoo placed ~ include right or left sideas well as approximate size in inches

Check each to confirm

• I confirm I have read and carefully reviewed the above information and instructions before submitting.
• I confirm I have prepared, or will prepare, and will comply with the requirements outlined above

Submit