I declare under my own responsibility that:
I am over 18 years old;
I have not consumed alcoholic beverages or narcotics before getting the tattoo;
I do not suffer from the following diseases and/or physiological conditions: diabetes, hemophilia (difficulty in stopping bleeding), epilepsy, heart diseases, dermatological conditions, skin injuries or sensitivity to soaps, disinfectants, or other cosmetic products, allergic reactions to metals, pigments, dyes, or other skin sensitizers, infectious diseases, fainting spells, stroke, narcolepsy, immune deficiencies, mental disabilities, hepatitis, AIDS, pregnancy, breastfeeding.