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CONSENT AND LIABILITY FORMS

The State of Wisconsin and Berserker Body Art require both consent and liability forms to be signed before a tattoo, piercing, or tattoo removal can be performed. These are kept for a minimum of 2 years per state law.

Wisconsin Department of Safety and Professional Services

Office Location: 4822 Madison Yards Way LicensE Portal: License.wi.gov

Madison, WI 53705 Email: dsps@wisconsin.gov

Phone Number: (608) 266-2112 Website: http://dsps.wi.gov

DIVISION OF PROFESSIONAL CREDENTIAL PROCESSING

INFORMED CONSENT TO TATTOO PROCEDURE

Under Wis. Admin. Code § SPS 221.10(1)(a), a tattooist may not tattoo a patron without first obtaining the signed, informed consent of the person on a form approved by the Department of Safety and Professional Services (Department).

Patron Information:

Name:

(first, last, MI)

Date of birth
Month
Day
Year
Have you been hospitalized in the last 12 months?
No
Yes
Are you suffering from a medical condition, illness or injury?
No
Yes

Let's Get Started!

Ready to start the process of tattoo removal? Book your free consultation with us today!

berserkerbodyart@gmail.com

berserkerbodyart.booksy.com

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