Laser Waiver Please enable JavaScript in your browser to complete this form.Reminder for your appointment today! Please check ✔️ That your aware of the following *Your appointment is today!? please be sure to fill out the form entirely 1-2 hours prior to arrival. If you fill this out early- you will be asked to fill out again when you arrive😣Do you have any CUTS, SCRATCHS, BUG BITES, RASH, ABRAISIONS OF ANY KIND , OR BURNS WITHIN 6 INCHES OF THE TATTOO AREA -? PLEASE CHECK NOW BEFORE YOU GO ANY FURTHER WITH THIS WAIVER - WE CAN NOT TATTOO WITH ANY OF THESE SKIN CONDITIONS NO MATTER HOW MINOR! You must eat 1-3 hours prior to arrival of your tattoo I understand I can not be fasting or dieting the day of my procedure and the impact they have on my tattoo proceeded. Should your artist feel you have not prepared adequately you could be asked to reschedule for another time. Failure to eat properly could result in low sugar (hypoglycaemic episode) you could pass out and we will need to stop the tattoo at that time. Even if your session ismincompleteYou need to bring a snack and a sugary drink with you (Not water or sugar free! This is for recovery if you feel faint)No alcohol or drug use 24hr before coming - includes marijuana. Limit your caffine and advil intake as this will cause excessive bleeding and bruising and could affect the outcome of your tattoo removalCovid/health pre-screening - please check if any apply to youits easier for me to reschedule 1 you- than risk myself becoming i’ll and having to reschedule many people- so please answer truthfully *CoughFever -higher than 37.8 C or 100FShortness of breath-that are not known for any other health issue you may haveSore throat-not related to allergies or other medical conditions you normally haveDifficulty swallowingRunny or stuffy noseDecrease or loss of taste or smellNausea,vomiting, diarrhea, stomach painPink eyeUnusual headache if your not prone.Muscle spasmsExtreme fatigue/tirednessSomeone you live/work with currently waiting covid-19 test results?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 been identified as been in contact with someone who currently has covid-19You have any medical conditions that could affect the tattoo proceedure or healing of your tattooyou have been vaccined within the last 14 days or going to have vaccine within 14 days this applies. As the vaccine greatly impacts your immune system and could affect healing time. None of the aboveWe request 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 our artists, staff and others who may be attending our facility.Name *FirstLastPhone *Email *EmailConfirm EmailIf under 18, please upload government photo id, Click or drag files to this area to upload. You can upload up to 2 files. Both you and your legal guardian/birth parent must upload photo’s for consent. And parent/legal guardian must be on premises fir duration of tattoo process Medical background - please check all that apply *Currently taking blood thinnersFaint or dizzy spellsDiabetesHIV/AIDSHemophilia or similar blood disordersHeart conditionEpilepsySkin conditions : eczema/psoriasisTuberculosis (TB)History of scarring or keloidHerpiesAsthmaHepatitisPregnant/nursingNON OF THE ABOVELegal stuff..Please check all below to be permitted for tattoo removal *I fully understand that these risks, known and unknown, can lead to injury, including but not limited to infection, scarring, difficulties in detecting melanoma and allergic reactions to tattoo pigment, latex gloves, and/or soap. Having been informed of this information I still wish to proceed with my tattoo removal I agree/understand the tattoo removal process is an invasive procedure and consists of removing the imbedded dyes &/or pigments in the skin with laser & the tattoo removal will be permanent that if i have any allergies to certain food or any organic materials this has been explained to me in my consultation & wish to proceed at my own risk.I agree I do not have a heart condition if i do, i have spoken with my doctor and have been advised of any concerns and still wish to proceed with this proceedure at my own riskI am not under the influence of drugs or alcoholI have not had hepatitis within the last year. I am not a haemophiliac (bleeder).To my knowledge, i do not have a physical, mental, medical impairment or disability which might affect my well being as a direct or indirect result of my decision to have tattoo, piercing or laser removal treatment work done at this time.I agree I WAIVE AND RELEASE to the fullest extent permitted by law each of the Artist and the Tattoo Studio from all liability whatsoever, for any and all claims or causes of action that I, my estate, heirs, executors or assigns may have for personal injury or otherwise,including any direct and/or consequential damages, which result or arise from the application of my tattoo, whether caused by the negligence or fault of either the Artist or the Tattoo Studio, or otherwiseI agree I release all rights to any photographs taken of me and the tattoo and give consent in advance to their reproduction in print or electronic form. (If you do not initial this provision, please advise and remind your Artist and the Tattoo Studio NOT to take any pictures of you and your completed tattoo!I agree/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 ArtBoth the Artist and the Tattoo Studio have given me the full opportunity to ask any and all questions about the application of my tattoo and all of my questions have been answered to my total satisfaction I am not the recipient of an organ or bone marrow transplant OR IF I AM I have taken the prescribed preventive regimen of antibiotics that is required by my doctor in advance of any invasive procedure such as tattooing or piercing Or Laser Tattoo RemovalI understand that Verbal AND written aftercare will be provided to me at the time of/after the procedure. I have also taken the time to review the aftercare requirements@ www.inkisart.ca/aftercare, and my aftercare requirements have already been explained during my consultation I am prepared to adhere to all the requirements necessary to heal my tattoo I am aware that infection could happen at no fault of the artist and should I experience any pain or swelling or symptoms of infection I should seek prompt medical attention within 24 hoursPLEASE NOTE: By clicking submit (below) you (If under 18, your legal guardian) agree to all terms set forth in this waiver and agree to proceed with a tattoo by an artist at Ink Is Art Tattoo Lounge.Submit Questions? call 905-665-9305
