First Name *

Last Name *

Phone *

Email *

Home address *

Photo ID check *

I have provided valid photo ID and confirm I am aged 18 or over.

Photo ID verified

Photo and video consent *

Yes, I consent to photos or videos of my tattoo being used by Jaded Tattoo Studios for its portfolio, website and social media.

No, I do not consent to photos or videos being used.

Photo consent

Date of birth *

Doctor and any other relevant medical information

Medication and allergies *

Medical conditions, health concerns or relevant history *

Who is carrying out your tattoo? *

How did you hear about us? *

Tattoo design and placement *

Emergency contact name and phone *

I have answered all of the questions honestly, understand tattooing is permanent, accept the normal risks, and consent to the tattoo described being carried out.

Client signature *

Clear

Consent date *

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Marketing preferences *

I would like to receive offers by email.

I would like to receive offers by SMS.

I would like to receive offers by email and SMS.

I do not wish to receive marketing offers.