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PLANET ARTZ STUDIO 

CONSENT FORM

How did you hear about Jai/ Planet Artz Studio?
Has a physician told you that you have hepatitis?
Yes
No
Have you been diagnosed with jaundice (yellowing of the skin or eyes) in the previous 10 days?
Yes
No
Are you prone to fainting?
Yes
No
Do you have diabetes?
Yes
No
Do you have difficulty stopping bleeding?
Yes
No
Do you take blood thinners?
Yes
No
Do you have heart related issues?
Yes
No
Do you have high blood pressure?
Yes
No
Have you consumed any alcoholic beverages within the last 8 hours?
Yes
No
Are you pregnant?
Yes
No
Have you consumed any food within the last 2 hours?
Yes
No

Its wise to eat a full meal before being tattooed.

Have you consumed any anticoagulants (Asprin, Ibuprofen, etc) in the last 24 hours?
Yes
No
Do you have any known conditions that might affect the healing of this tattoo?
Yes
No
Artist has my consent to photograph and publish of said tattoo on social media and or affiliated website(s)
Yes
No
Date of Birth
Día
Mes
Año
Modo de dibujo seleccionado. Para dibujar, necesitas un mouse o un panel táctil. Usa la función de accesibilidad del teclado al seleccionar Escribir o Subir.
Today's Date
Día
Mes
Año
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