Postcode:

Mobile Number:

Emergency contact Number:

Birth Date:

Gender:
MaleFemaleOthers

How did you hear about us?:

Passport/Driver ID*:

Please Take A Picture Of Your licence
The field is required.

Choose your artist:
—Guest ArtistTeneile NapoliKarlee SabrinaMiss KimberleyJuannita TahereBriar BrodersonTayler TrotterPaytan AmberAmityLadySkyEmily TaylorCrystal RoseGiorgia MaeCinnamonaMatt Comben

Please Circle Yes or NO Truthfully To The Statements And Questions Below

I am 18 years of age or over:
YesNo

Have you eaten within last 4 hours?:
YesNo

Have you consumed alcohol within last 8 hours?:
YesNo

Are you prone to dizzy spells or fainting?:
YesNo

Are you prone to heavy bleeding?:
YesNo

Are you currently taking any blood thinning medicine? (Aspirin, steroids etc):
YesNo

I understand that taking blood thinning agents can affect the healing process of my tattoo:
YesNo

I am completely responsible if this outcome occurs:
YesNo

Are you currrently taking any non-prescribed drug? (Marijuana, Methamphetamine etc):
YesNo

Do you have any fears of medical procedures?:
YesNo

I acknowledge that I am totally responsible for looking after my tattoo during the healing process:
YesNo

I understand that Garage Ink uses top sterilised equipment and single use needles for each new client?:
YesNo

I understand that if I have severe sunburn or rashes, I will be refused my tattoo :
YesNo

I understand that suggestions offered by the tattooist regarding design and placement are offered in accordance with their training and experience :
YesNo

I understand that suggestions offered from the tattooist are offered in accordance with their training and experience but is not to be confused with professional medical advice. :
YesNo

Do you have any additional allergies that we need to be made aware of (e.g. latex, oils and soaps) please indicate? :
YesNo

Declaration

For the safety of yourself and your tattoo artist please indicate by circling if any of these conditions apply to you:

Heart DiseaseDiabetesEpilepsyHIV/AidsHepatitisPoor HeatingPregnant/BreastFeeding KeloidingNone of these

This is to certify that I, the customer named above do give permission to be tattooed at Garage Ink, I have answered all off the above questions truthfully and honestly, I am fully aware of the process involved and understand the importance of applying the daily aftercare.