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Formulier succesvol verzonden!

Je ontvangt een bevestiging per e-mail met een kopie van dit formulier en de nazorg-instructies.

Tattoo Piercing Tattoo Removal (Laser) Micro Hair Pigmentation (MHP) PMU / Microblading Apprentice Tattoo

Datum van je afspraak *

Tijd van je afspraak (optioneel)

Wat gaan we doen? (optioneel)

Waar op je lichaam? (optioneel)

Kortingscode (optioneel) Heb je van ons een persoonlijke code gekregen per mail? Vul hem hier in.

Full name *

Street + house number *

Postal code *

City *

Date of birth *

Email address *

Phone number *

Hemophilia

Yes No

Chronic skin condition

Yes No

Contact allergy

Yes No

Diabetes

Yes No

Immune disorder

Yes No

Cardiovascular conditions

Yes No

⚠️ Waarschuwing: Getting a tattoo is strongly discouraged if one or more conditions apply. Please contact your doctor.

I have chosen this tattoo deliberately and of my own free will. I have been informed of the risks of infection and other complications resulting from tattooing. I have been informed of the risks of using tattoo materials with health conditions such as diabetes and hemophilia. Aftercare instructions for my tattoo can be found at www.tat2holics.com. After being tattooed I will receive these in writing and they will be explained verbally. I consider myself healthy enough to have this tattoo done. I am not under the influence of alcohol or drugs during the treatment. I am aware that getting a tattoo is discouraged when using antibiotics or anticoagulants. I am aware that pregnant women are advised against getting a tattoo due to increased risk of infection.

Please note: You are under 16 years of age. Signature and presence of a parent or legal guardian is required.

Please note: You are between 16 and 18 years of age. Consent of a parent or legal guardian is required.

Parent / guardian name *

Parent / guardian ID number *

Parent / guardian phone number *

I, as parent/guardian, hereby give consent for the treatment of the above-named minor. *

Tat2Holics 📍 Lekstraat 227, 2515 XE Den Haag 📞 06 26120203 ✉️ [email protected] KvK 70215480 BTW NL002040076B34 4.9★ uit 217+ Google Reviews

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