Skip to content
About
Portfolio
Blog
Booking
Contact
About
Portfolio
Blog
Booking
Contact
Consent Form
Wear Your Demons in Ink
First Name
*
Last Name
*
Email Address
*
Phone
*
Street Address
*
Apartment, suite, etc
City
*
State/Province
*
ZIP / Postal Code
*
Country
*
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China, People's Republic of
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
France, Metropolitan
French Guiana
French Polynesia
French South Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island And Mcdonald Island
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Johnston Island
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion Island
Romania
Russia
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre & Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and South Sandwich
Spain
Sri Lanka
Stateless Persons
Sudan
Sudan, South
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan, Republic of China
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks And Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America (USA)
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis And Futuna Islands
Western Sahara
Yemen
Zambia
Zimbabwe
Date of Birth
*
Instagram Handle
I confirm that I am 18 years of age or older.
*
Yes
Do you have any allergies (latex, iodine, metals, etc.)
*
No
Yes
Are you pregnant or nursing?
*
No
Yes
Are you currently under the influence of drugs or alcohol?
*
No
Yes
Have you taken any blood thinners (aspirin, ibuprofen, etc.) in the past 24 hours?
*
No
Yes
Do you have any skin conditions (psoriasis, eczema, etc.)?
*
No
Yes
Do you have a communicable disease (Hepatitis, HIV, etc.)?
*
No
Yes
Do you have any medical conditions (diabetes, epilepsy, cardiovascular issues, blood disorders, etc.)
*
No
Yes
Please upload a picture of your driver's license, passport, state issued ID, or valid government identification:
*
Drag and Drop (or)
Choose Files
Acknowledgement
*
By signing, I acknowledge:
Tattooing is a permanent procedure.
The artist cannot guarantee I won’t experience an allergic reaction.
I have disclosed all relevant medical history.
I have been given aftercare instructions and understand that failure to follow them can result in infection or poor healing.
No refunds will be issued for tattoos once started.
I release and hold harmless Osy Tattoo, its artist(s), and affiliates from any liability related to my tattoo session.
I consent to photographs/videos of my tattoo being used for the artist’s portfolio, website, and social media.
If I am unable to complete the tattoo session due to pain tolerance, scheduling conflicts, or other personal reasons, I understand I may be subject to additional costs for future appointments needed to finish the piece.
I agree and understand that by signing this digital consent form via Osytattoo.com that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.
*
Submit Consent Form
Please do not fill in this field.