By filling out this form of consent I understand that this free procedure is only for people in extreme circumstances who need removal to kickstart a fresh start at life. This can include tattoo removal of visible areas (hands, neck and face), offensive tattoos or tattoos that are a harsh reminder of an unfortunate circumstance from the past.

I also understand that tattoo removal is a process that requires more than one treatment. If successful, I agree to attend each and every scheduled appointment on time. If an appointment is not kept or cancelled with 48 hours’ notice (with the exception of extreme circumstances), I will be immediately terminated from the program to allow for another committed applicant to take my place.