Tattoo procedure agreement
With the risks of a new coronavirus infection spreading, please answer the following questions
Name
Phone number
E-mail
Date of Birth
I certify that I am over 18
yes
no
Passport data (series, number)
without space*
Address
(according to passport)
Have you had contact with infected people or has anyone close to you been exposed to COVID-19?
yes
no
Have you traveled abroad?
yes
no
I am absolutely sure that I do not have any bleeding problems, do not suffer from cardiovascular diseases, and am not pregnant or breastfeeding at the time of the procedure (for women)
yes
no
I agree to report if I have an allergy or any other medical condition
including colds, flu, COVID-19, hepatitis, HIV, AIDS, diabetes, CNS disease
yes
no
I consent to the tattoo procedure
according to my approved sketch using sterile instruments and disposable consumables
yes
no
How did you know about me?
Instagram
Internet advertising
Media article
Friends recommendation
Im ready to follow @sonyapokesyou tattoo care recommendations
yes
no
Consent is valid for the period until the goals of processing are achieved and can be withdrawn by sending a corresponding request to the address of the operator
I confirm the agreement
Send
By clicking the button, you agree to the processing of personal data and agree to the
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Made on
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