Sorry Mama Tattoos Utrecht

Consent form

Information for the client with the consent form:

Please read the following information carefully and inform the tattoo artist if you have any doubts about your eligibility to be tattooed.

Tattooing and the healing process can come with risks and potential complications. You will be given follow-up care instructions after your appointment to help you minimize the effects.

It is normal for tattooing to be accompanied by pain, redness and swelling. If these symptoms worsen during the healing process, it could be a sign of an infection and you should see a doctor.

Some complications may be related to your health situation. It is important for your safety that the tattoo artist is informed of this. Additional precautions may be necessary.

Tattoos are permanent and, depending on the ink used, they may not be able to be removed properly.

If in doubt, treatment should be delayed, and medical advice should be sought.

Do not get a tattoo:

  • If you are pregnant or breastfeeding.
  • If you are under the influence of alcohol or drugs.
  • On a birthmark or a scar left after a melanoma has been removed. (Skin cancer type)

The following conditions or conditions may put you at a higher risk of complications:

1) Skin:

  • Skin infection regardless of location and type of infection allergies (please specify if you have an allergy, e.g., latex allergy, allergy to metals and preservatives)
  • Areas of skin that appear damaged or abnormal, including moles
  • Any skin diseases that are active (e.g., eczema, psoriasis)
  • Areas of skin that have been subjected to plastic surgery or radiotherapy including recent scars and keloids (according to medical advice)
  • A previously tattooed spot that has not completely healed
  • A place where a tattoo has recently been lasered or removed by another method if the wound has not yet healed

2) General Disorders:

  • Haemophilia or another coagulation disorder
  • Epilepsy, cardiovascular disease
  • Known allergies (e.g., latex allergy)
  • Diabetes
  • An autoimmune disease
  • Immunosuppression and immune compromised disorders
  • Sarcoidosis


If any of the above circumstances or conditions apply to you and you still want a

  tattoo, please consult your doctor first and seek advice.

Client Statements:

  • I have considered all information.
  • I have been informed about possible risks and complications associated with getting the tattoo and I understand the information.
  • I am not currently under the influence of alcohol or drugs or any other substance that may affect my perception, free will and judgment.
  • The aftercare procedure has been clearly explained to me and I understand what actions to take and what precautions to take. I received my own copy of the aftercare procedure.
  • I give permission for the tattooing to be carried out as described in this form.
  • I confirm that the tattoo artist may keep this consent form on file.
  • I am aware of and accept the risks and potential complications associated with getting a tattoo.
  • I confirm that I have given all information in these documents and statements to the best of my knowledge and belief and that they are correct.
  • Danique’s Tattoofabrique is not responsible for the correct spelling of texts. Check in advance whether what you are getting tattooed is correct.


PLEASE NOTE: Do not fill in this form until you are present in the shop.

*By entering your details you declare that you have gone through all of the above and that you agree with this