top of page

Book Online.
Tattoos.
Piercing.
Illustration.
More

Use tab to navigate through the menu items.

Booked in with me?

Tattoo or piercing, please fill out the consent form below:

Consent Form

First name*

Last name*

Email*

Phone

Date of Birth*

Day

Month

Year

Must be +16 for piercings, +18 for tattoos.

Age*

I am here for a*

Tattoo

Piercing

Please upload a photo of your ID:

If required.

Please indicate anything that applies to you and your health:

Have you eaten before your appointment?*

Yes

Are you under the influence of drugs or alcohol?*

Yes

In the last 14 days, have you been unwell in any way?*

Yes

eg. cold, flu, stomach bug, etc.

Are you pregnant or nursing?*

Yes

Do you suffer from any heart conditions/blood pressure problems?*

Yes

Do you have Epilepsy?*

Yes

Do you suffer with any condition that effects your immune system?*

Yes

Do you have Diabetes?*

Yes

Do you suffer from Haemophilia or any other blood clotting condition?*

Yes

Do you have any known blood borne viruses?*

Yes

eg. Hep B, Hep C, Hep D, HIV, etc.

Have you had any problems with skin healing in the past?*

Yes

eg. Psoriasis, Eczema, Impetigo, etc.

Have you prone to any allergic reactions?*

Yes

eg. Latex, Nickel, Plasters, etc.

If yes, what are you allergic too?

Do you take any prescribed medication regularly?*

Yes

Including any antibiotics you may be taking.

If yes, what are you taking?

Are you prone to fainting or dizzy spells?*

Yes

Anything else we should know about?

I declare that I give my full consent to the tattooing/piercing being carried out by the practitioner.

I fully understand that this is a permanent change to my body, and I understand that potential complications (such as swelling and infection) can arise if I do not follow the aftercare as advised.

I confirm that the above information provided by me for this consent form is correct to the best of my knowledge.

Signed:*

Signature field is empty.

Find Me

Alley Cats Tattoo & Laser

74 Lower Parliament Street, Nottingham NG1 1EH

Contact

Opening Hours

kt.tattoos94@gmail.com

Wed - Sat

11am – 5pm

(roughly)

BOOK IN

bottom of page