OSCO
Tattoo Consent and Release Form
First Name
Last Name
Email
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Telephone Number
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City
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Country
Afghanistan
Albania
Algeria
American Samoa
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Anguilla
Antarctica
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Austria
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Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, The Democratic Republic of the
Cook Islands
Costa Rica
Cote D"Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
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Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
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French Guiana
French Polynesia
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Gabon
Gambia
Georgia
Germany
Ghana
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Grenada
Guadeloupe
Guam
Guatemala
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Guinea
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Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
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India
Indonesia
Iran, Islamic Republic Of
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
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Kenya
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Korea People's Democratic Republic
Republic of Korea
Kuwait
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Land Islands
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
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Liechtenstein
Lithuania
Luxembourg
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Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Federated States of Micronesia
Moldova, Republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory, Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
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Samoa
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Sao Tome and Principe
Saudi Arabia
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Serbia
Seychelles
Sierra Leone
Singapore
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Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
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Sudan
Suriname
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Eswatini
Sweden
Switzerland
Syrian Arab Republic
Taiwan
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Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
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Tunisia
Turkey
Turkmenistan
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UK
Ukraine
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Uruguay
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Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
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Zimbabwe
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Which artist are you getting tattooed by?
Nicholas Dimpsey
Aarone Realmao
Sean Burtenshaw
Tom Boxell
Dominic Apuzzo
Em Doh
Betty Nyikes
Milan Boros
Paulina Hladkiewicz
Tanya Chaggar
Takko San
Aneae Rodriguez
Roudolf Dimov
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Referred by:
TikTok
Facebook
Instagram
Google Search
YouTube
Customer Referrals
Other Businesses
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Do you have Flu like symptoms? (Please notify a member of staff immediately if you answer "Yes.")
Yes
No
Medical conditions (Please tick all that apply.)
Eczema, Psoriasis, Acne or other skin condition - (more prone to skin infections)
Heart Disorders - (more prone to serious heart conditions from any blood infections)
High/Low Blood Pressure - (can cause light headedness)
Haemophilia and other blood disorders - (may result in poor clotting/healing)
Epilepsy or other form of seizures - (medication may cause side effects and may result in fitting during treatment)
Diabetes - (can reduce healing properties of the skin resulting in infection)
Hepatitis - (can pose a risk for operator)
Allergies - (may result in serious skin reaction present in products; ink/latex)
Pregnant - (immune response affected by pregnancy and infection may affect the unborn child; we can't tattoo you if you are pregnant)
Nursing - (risk of infection can be a risk to the baby)
Medication - (side effects may affect healing and recovery from treatment)
Autoimmune Disease or treatment causing it e.g. cancer treatment - (more prone to serious infection, a risk for operator)
Recipient of an organ/bone marrow transplant - (if so you have taken the preventative antibiotics)
None of the above
Any other medical conditions not listed - please give details below.
Confirmation
I confirm that I have been fully informed of the inherent risks, associated with getting a tattoo. I fully understand that these risks, known and unknown, can lead to injury, including but not limited to; infection, scarring, difficulties in detecting melanoma and allergic reactions to tattoo pigment, latex gloves, and/or soap. Having been informed if the potential risks, I still wish to proceed with the tattoo application and I freely accept and expressly assume any and all risks.
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