Tattoo Health Questionnaire Template

A health questionnaire helps you identify conditions that might affect the tattoo or healing process. It's a simple way to start conversations about any concerns before you start working.

Last updated June 5, 2026

TemplateCopy and customize for your shop

Health Questionnaire

Client: [Client Name]

DOB: [Client Dob]

Please answer each question truthfully:

•Pregnant or breastfeeding?

Yes

Allergies (if any)::

Current medications (if any)::

•Bleeding disorder?

Yes

•Diabetes?

Yes

•Heart condition?

Yes

•Skin conditions?

Yes

If yes, describe::

•Immune system issues?

Yes

•Recent surgery?

Yes

If yes, provide details::

Other notes::

I certify that I have answered the above questions truthfully and to the best of my knowledge.

Client Signature: ______ Date: ______

Artist/Staff Signature: ______ Date: ______

How to use this form

• Review answers before starting — don't just file it away
• If a client checks concerning boxes, have a conversation before proceeding
• Clients on blood thinners may bleed more — plan accordingly
• Accutane affects skin healing for months after stopping
• When in doubt, ask clients to get clearance from their doctor

Frequently Asked Questions

What is a tattoo health questionnaire?

A health questionnaire is an intake form clients complete before tattooing. It screens for conditions, allergies, and medications that can affect bleeding, healing, or safety. It helps you spot concerns early and start a conversation before the needle touches skin.

What health conditions should I screen tattoo clients for?

Common ones include pregnancy, diabetes, bleeding disorders, heart conditions, immune issues, skin conditions at the tattoo site, and recent surgery. Also ask about blood thinners and Accutane, which affect bleeding and healing. The form is a screening tool, not a diagnosis.

What should I do if a client discloses a medical condition?

Don’t just file the form, read it. If a client checks a concerning box, have a conversation before proceeding. Clients on blood thinners may bleed more, and some conditions warrant a doctor’s clearance first. When in doubt, ask them to get medical sign-off.

Is a tattoo health questionnaire legally required?

Requirements vary by state and local health department. Even where it isn’t mandatory, screening is a professional best practice that protects clients and documents your due diligence. Check your local regulations, and keep completed forms on file as long as your insurance requires.

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Disclaimer: This template is provided as a general starting point and is not legal advice. Laws vary by location. Consult a lawyer before using this in your business. Apprentice is not responsible for any legal issues arising from the use of these templates.

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