Name *

First Name

Last Name

Have you had any skin laser removal treatment or tattoo removal service anywhere on your body within the last 12 months? *

YES

NO

Do you have or are you prone to any of the following? *

ALLERGIES / SENSITIVITIES

REDNESS

SWELLING

IRRITATIONS

SKIN CONDITIONS

NONE

DISCLAIMER : Tattoo Coverage service includes the use of professional grade makeup products that are waterproof and transfer resistant. Compromised skin, laser removals (within 12 months), certain skin types, skin conditions, medications, body lotions or oils and excessive alcohol consumption can effect the application and longevity of the coverage. Therefore tattoo coverage cannot be guaranteed. *

YES, I UNDERSTAND

I have given an accurate and honest account of the questions asked above including all allergies, prescription drugs and products I am currently ingesting or topically using. I will hold CTL ARTISTRY harmless from any skin reactions that may result from the tattoo coverage and makeup products applied to the tattoo area. *

YES, I AGREE & CONSENT

I understand my artist will take every precaution to minimize any skin reactions, I accept the possible risks. I am willing to follow recommendations for after care service that can minimize possible negative reactions and result in the best outcome of my services. *

YES< I AGREE & CONSENT

I agree that this constitutes full disclosure, or written disclosures. I certify that I have read and fully understand the above information and I have been provided sufficient opportunity to discuss any questions or concerns. I understand the process and procedure of my service and except the risks. I do not hold CTL Artistry, the stylist or salon responsible for any of my conditions that were present but did not disclose at the time of this procedure which might be affected by the treatment performed today. *

YES, I AGREE & CONSENT