MINOR PROHIBITION: I affirm that I am at least 18 years of age. I understand that under Arkansas Code § 20-27-2101 et seq., it is unlawful to tattoo any person under the age of 18, regardless of parental consent. I have presented valid, government-issued photo identification, and the artist has verified my age.
HEALTH WARNINGS: I acknowledge that I have been verbally informed and understand the following health warnings as required by Arkansas law:
The tattoo procedure involves the placement of pigment under the skin with a needle.
Possible risks include, but are not limited to: infection, allergic reaction to pigments, scarring, granulomas, keloid formation, MRI complications, and the potential for disease transmission (including hepatitis and HIV) if proper sterilization and sanitary procedures are not followed.
Tattoos are permanent and removal may be difficult, painful, expensive, and may not completely erase the tattoo or may result in scarring.
AFTERCARE RESPONSIBILITY: I acknowledge that I have received and understand written aftercare instructions. I accept full responsibility for the care of the tattoo during the healing process. I understand that failure to follow aftercare instructions may result in increased risks, including infection, poor healing, scarring, and loss of pigment or detail in the tattoo.
CONSENT TO PROCEDURE: I consent to the application of the tattoo and the associated process, including the use of sterile, single-use needles and appropriate hygienic practices as required by the Arkansas Department of Health. I verify that the placement and design are as I have requested and that the stencil has been applied and approved by me.
HEALTH DECLARATION: To the best of my knowledge, I affirm that:
I am not under the influence of alcohol or drugs.
I do not have a medical condition that would impair my body's ability to heal (e.g., hemophilia, diabetes, immune disorder).
I am not pregnant or nursing.
The area to be tattooed is healthy, with no cuts, abrasions, rashes, sunburn, or active infection.
I am not aware of any allergies to pigments, latex, or topical preparations to be used.
RELEASE OF LIABILITY: In consideration of receiving this tattoo, I, for myself and my heirs, executors, and assigns, hereby release, indemnify, and hold harmless ROYAL HAND TATTOO, its owners, artists, and employees from any and all claims, damages, or legal actions arising from or connected in any way with my tattoo procedure, including but not limited to those based on negligence, any latent or unforeseen complications, allergic reactions, infections, or the ultimate appearance of the healed tattoo. This release is binding under the laws of the State of Arkansas.
ACKNOWLEDGMENT OF UNDERSTANDING: I confirm that I have had the opportunity to ask questions, that all my questions have been answered to my satisfaction, and that I have read, understood, and agreed to all the terms of this consent form before signing. I am consenting freely and voluntarily.
