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CONSENT

Tattoo Consent Form

Katie Haus, Firefly Tattoo - 502 W 4th Street, Suite 8, Bloomington, IN 47404

When you submit this form, it will not automatically collect your details like name and email address unless you provide it yourself.

Step 1 of 4

Step 1: Your Information

Your full name:

Pronouns:

Age (e.g. 34):

Date of birth (M/d/yyyy): M/D/YYYY

Phone number:

Email address:

Address:

Description of tattoo:

Location of tattoo:

Firefly Tattoo LLC

502 W 4th St Suite 8, Bloomington, IN 47404

Custom folk and nature-inspired tattoo artist Katie Haus in Bloomington, Indiana.

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