TATTOO WAIVER, CONSENT & PHOTO RELEASE FORM

Artist: Kevin Taubman
Date: _______________

CLIENT INFORMATION

Full Name: _________________________________
Date of Birth: _______________ Age: _______
Phone Number: _________________________________
Email Address: _________________________________

MEDICAL DISCLOSURE & HEALTH QUESTIONNAIRE

I acknowledge that I must disclose all relevant medical information as required by Minnesota law. I understand that failure to provide accurate information may result in serious health complications.

Please check all that apply:

☐ Diabetes
☐ Epilepsy
☐ Heart conditions
☐ Bleeding disorders (hemophilia)
☐ Skin diseases (eczema, psoriasis)
☐ History of keloid scarring
☐ HIV
☐ Hepatitis (A, B, or C)
☐ Severe allergies
☐ Pregnancy or nursing
☐ None of the above

Current Medications (especially blood thinners or acne medications like Accutane):

Additional Medical Conditions or Concerns:

LIABILITY RELEASE & ASSUMPTION OF RISK

I understand and acknowledge the following risks associated with tattooing:

• Infection - Including bacterial, viral, or fungal infections • Allergic reactions - To inks, aftercare products, or cleaning solutions • Scarring - Permanent scarring may occur • Color fading - Colors may fade or change over time • Unsatisfactory results - Final appearance may not meet expectations • Nerve damage - Temporary or permanent nerve damage in rare cases

I voluntarily assume all risks associated with receiving a tattoo from Kevin Taubman. I understand that no guarantee has been made regarding the final appearance or healing of my tattoo.

I hereby release, discharge, and hold harmless Kevin Taubman from any and all claims, damages, losses, or expenses arising from my tattoo session, including but not limited to medical expenses, pain and suffering, or any other damages.

CONSENT TO TATTOO

☐ I am 18 years of age or older and legally able to consent to this procedure
☐ I am under 18 and have parental/guardian consent (where legally permitted)

I consent to the tattooing procedure and understand that:

• The tattoo is permanent and removal is expensive and may not be completely successful

• I must follow all aftercare instructions provided by the artist

• I will not hold the artist responsible for poor healing due to my failure to follow aftercare

• Touch-up sessions may be necessary and are subject to additional fees

• I have reviewed the design and placement of my tattoo and approve of both.

PHOTO RELEASE & MARKETING CONSENT

I grant Kevin Taubman permission to:

☐ Photograph my completed tattoo
☐ Use images for professional portfolio
☐ Display images on website and social media
☐ Use images in marketing materials and advertisements
☐ I DO NOT consent to photography or use of my tattoo images

I understand that:

• Photos will focus on the tattoo artwork, not identifying features

• I will not receive compensation for use of these images

• Images may be used indefinitely for professional purposes

ACKNOWLEDGMENT & SIGNATURES

By signing below, I acknowledge that:

• I have read and understand this entire document

• All my questions have been answered satisfactorily

• I am not under the influence of alcohol or drugs

• I have provided accurate medical information

• I voluntarily consent to this tattoo procedure

Client Signature: _________________________________ Date: ___________

Print Name: _________________________________

Parent/Guardian Signature (if under 18): _________________________________ Date: ___________

Artist Signature: _________________________________ Date: ___________
Kevin Taubman

This document serves as a legally binding agreement. Please retain a copy for your records.

Terms & Conditions

FAQs

Who is Kevin?

Kevin Taubman is the licensed tattoo artist handling your session.

Why medical info?

Minnesota law requires full disclosure to avoid health risks during tattooing.

What if I have conditions?

Please check all that apply on the form, like diabetes or skin diseases, so we can ensure your safety.

Is photo release needed?

Yes, it allows sharing your tattoo photos for portfolio or promotion.

Can I change info later?

Please provide accurate info upfront; updates should be discussed with Kevin.

What happens if I withhold info?

Failing to disclose medical details may cause serious health complications during or after tattooing.