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Consent Form

In consideration of receiving a tattoo from Capio Tattoo Studio, including its artist, associates, apprentices, agents, or any employees (hereinafter referred to as the “Tattoo Studio”) I agree to the following:
- I have been fully informed of the inherent risks associated with getting a tattoo. Therefore, I fully understand that these risks, known and unknown, can lead to injury including but not limited to: infections, scarring, difficulties, in the detection of melanoma and allergic reactions to tattoo pigment, latex gloves and/ or soap. Having been informed of the potential risks associated with getting a tattoo. I wish to proceed with the tattoo procedure and application. I freely accept and expressly assume any and all risks that may arise from tattooing.
- I WAIVE AND RELEASE to the fullest extent permitted by law any person of the Tattoo Studio from all liability whatsoever, including but not limited to, 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 of either the Tattoo Studio or otherwise.
- The Tattoo Studio has given me the full opportunity to ask any questions about the procedure and application of my tattoo and all of my questions, if any, have been answered to my total satisfaction.
- The Tattoo Studio has given me clear and precise instructions on the care of my tattoo during the healing process. I acknowledge and understand the instructions given to me. I also acknowledge that if I do not follow the instructions given that it is possible the tattoo can become infected. If any touch-up work to the tattoo is needed due to my own negligence, I agree that the work will be done at my own expense.
- I am not under the influence of alcohol or drugs, and I am voluntarily submitting to be tattooed by the Tattoo Studio without duress or coercion.
- I do not suffer from Diabetes, Epilepsy, Hemophilia, any and all Heart Conditions, nor do I take blood-thinning medication. I do not have any other medical or skin conditions that may interfere with the procedure, application, or healing of the tattoo. I am not the recipient of an organ or bone marrow transplant or, if I am, I have taken the prescribed preventative regimens of antibiotics that is required by my doctor in advance of any invasive procedure such as tattooing or piercing. I am not pregnant or nursing. I do not have a mental impairment that may affect my judgment in getting the tattoo.
- The Tattoo Studio is not responsible for the meaning or spelling of symbols or texts that have been provided to them or from any chosen on the flash (design) sheets.
- Variations in color and design may exist between the tattoo I have selected and the actual tattoo when it is applied to my body. I also understand that over time, the colors and the clarity of my tattoo will fade due to unprotected exposure to the sun and the naturally occurring dispersion of pigments under the skin.
- A tattoo is a permanent change to my appearance and can only be removed by laser or surgical means, which can be disfiguring and/or costly and which in all likelihood will not result in the restoration of my skin to its exact appearance before being tattooed.
- I release the right to any photographs taken of me and the tattoo and give consent in advance to their reproduction in print and/or electronic form. (For assurance, if you do not initial this provision, please inform the Tattoo Studio NOT to take any pictures of you and your completed tattoo).
- I agree that the Tattoo Studio has a NO REFUND policy on tattoos, piercings and/or retail sales. I waive any and all rights and consent that I will not get a refund for any deposit(s) and/or total payments(s) made.
- I agree to reimburse the Tattoo Studio for any attorneys’ fees and costs incurred in any legal action I bring against the Tattoo Studio and in which either the Artist of Tattoo Studio is the prevailing party. I agree that the courts located in the County of Westchester within the State of New York shall have jurisdiction and venue over me and shall have exclusive jurisdiction for the purposes of litigating any dispute(s) arising out of or related to this agreement.
- I acknowledge that I have been given adequate opportunity to read and understand this document. I acknowledge that it was not presented to me at the last minute and grasp that I am signing a legal contract waiving certain right to recover damages against the Tattoo Studio.
- I hereby declare that I am of legal age and have provided valid legal proof of age and identification. I acknowledge that I am competent to sign this agreement. If any provisions, sections, subsections, clause or phrase of this release is found to be unenforceable or invalid, that portion shall be severed from this contract. The remainder of this contract will then be construed as though the unenforceable portion had never been contained in this document.


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