your info
Full Legal Name *
Please print your full legal name.
Address *
Address is required.
health & allergies
Allergies (antibiotic ointments, latex, petroleum products, or anything else)
Skin & Health Notes (rashes, eczema/psoriasis, oily or very dry/cracked skin, moles or freckles in the area, diabetes, epilepsy, hemophilia, heart condition, blood thinners, pregnancy/nursing — anything relevant to the tattoo area or healing)
terms — please read & check each box
In consideration of receiving a tattoo from Francisco Tanchez (the "Artist") and The Thirteenth Floor Tattoo Lounge and its employees, apprentices, and agents, I have been fully informed of the inherent risks associated with getting a tattoo, including but not limited to infection, scarring, difficulty detecting melanoma, and allergic reactions to pigment, latex gloves, and/or soap. Having been informed of these risks, I still wish to proceed and I freely accept and expressly assume any and all risks that may arise from tattooing.
I have read and understand this section.