I acknowledge by signing this agreement that I have been given the full opportunity to ask any and all questions which I might have about my new tattoo, all of my questions have been answered to my satisfaction. I specifically acknowledge I have been advised of the facts and matters set forth below and I agree as follows:

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• If I have diabetes, epilepsy, hepatitis, hemophilia, HIV-AIDS, or any other communicable disease,heart condition or take medicines which thins the blood I have advised my tattooer.
   

• I am not pregnant or nursing. I am not under the influence of alcohol or drugs.
   

• I do not have medical or skin conditions such as but not limited to: acne, scarring, eczema, psoriasis, freckles, moles or sunburn in the area to be tattooed that may interfere with said tattoo. If I have any type of infection or rash anywhere on my body, I will advise my tattooer.
   

• I acknowledge that I might get an infection, in the event that I do not take proper care of my tattoo. I have received aftercare instructions and I agree to follow them while my tattoo is healing.
   

• I agree that any touch-up work needed, due to my own negligence, will be done at my own expense.
   

• I realize that variations in color and design may exist between any tattoo as selected by me and as ultimately applied to my body.
   

• I understand that if my skin color is dark, the colors will not appear as bright as they do on light skin.
   

• I understand that if I have any skin treatments, laser hair removal, plastic surgery or other skin altering procedures, it may result in adverse changes to my tattoo.
   

• To my knowledge, I do not have a physical, mental or medical impairment or disability which might affect my well being as a direct or indirect result of my decision to have a tattoo.
   

• I acknowledge I am over the age of eighteen. I have truthfully represented to my tattooer that the obtaining of a tattoo is by my choice alone. I consent to the application of the tattoo and to any actions or conduct of the representatives and employees of the tattoo shop reasonably necessary to perform the tattoo procedure.