Name *

First Name

Last Name

Client Conditions *

Please reschedule your appointment if all of the boxes below do not apply to you.

I confirm that there are no cuts, scratches, burns, rashes, bruising, or sunburn where I will be receiving my tattoo.

I confirm that I am not currently on any antibiotics or steroids.

I confirm that I am not currently experiencing any cold/flu symptoms.

I confirm that I am over the age of 18, and agree to provide a valid ID at my appointment.

I confirm that I am not currently pregnant or nursing.

I confirm that I do not have any surgery/procedure scheduled for the next 21 days.

Tardiness Policy *

I agree to do my best to be on time or early to my appointment, and will inform Stefani immediately if I know that I am going to arrive past my appointment time.

I understand that if I cancel with less than 48hrs notice, I may be charged 50% of the remaining session cost before rescheduling.

I understand that if I cancel with less than 24hrs notice (or will be 15 minutes late), I may be charged 80% of the remaining session cost before rescheduling.

Possible Last-Minute Rescheduling *

I understand that Stefani is working with a chronic medical condition, and there is a chance she may need to reschedule at the last minute due to her health. I agree to be courteous and work with her to reschedule our appointment if necessary.

I understand that Stefani does not drive in hazardous weather that could alter travel conditions, and I will not hold her to fault if she feels unsafe traveling to the studio.

Attendance *

Please select the appropriate response below for how to continue with your appointment.

I CONFIRM that I will attend my appointment on time, and I will uphold all policies agreed to above.

I would like to RESCHEDULE my appointment. I understand that I will be contacted via email to discuss a new date for my appointment.

I would like to enroll in the INDEFINITE RESCHEDULE LIST, therefore freezing my deposit and appointment until I am sure on a time when I can reschedule.

I would like to CANCEL my appointment, therefore forfeiting my deposit and appointment spot.

The Day of your Appointment:

When you arrive at Midway Arts, please park in whichever lot you prefer (there is a big and a small lot on either side of the building). Please message me to let me know you have arrived, and when I'm ready, I'll invite you upstairs! You can enter the lobby through the large glass doors on the street-side of the building, or there's a ramp entry in the small parking lot. Forms of payment: -Cash -Google Pay, Apple Pay, Venmo (5% fee) -Credit/Debit Card (5% fee) -Klarna, AfterPay (5% fee)

Got it!