Digital Consent | Rose City Originals

Full Legal Name

Email Address

Phone Number

A copy of this form will be sent to your email.

Disclosures & Waivers

I am 18 years of age or older and can provide valid government-issued photo ID. I do not have a medical or skin condition such as but not limited to: acne, scarring, eczema, psoriasis, freckles, moles, or sunburn in the procedure area that may interfere with the tattoo. I am not pregnant or nursing. I am not under the influence of alcohol or drugs. I acknowledge that infection is always possible as a result of obtaining a tattoo. I agree to follow all instructions concerning the care of my tattoo while it is healing. I understand that tattoos are permanent and that removing them requires surgical or laser procedures which may leave scarring.

Client Consent

Consent Recorded