Contact form for appointment at ZUK Tattoo

    1. PERSONAL DATA:








    Please send us a picture of your DNI, NIE or Password. If you have trouble sending it with this form, you can also send it later by e-mail: info@tattoolleida.com

    2. MEDICAL INFORMATION:

    Do you have any allergies or skin diseases?

    If you answered yes, specify which ones:

    Do you take any medication that affects blood clotting or do you have any heart disease?

    If you answered yes, specify which ones:

    COVID-19:

    Have you had a fever above 37.5º, cough or respiratory distress in the last 14 days?

    Have you noticed loss of sense of taste or smell in the last 14 days?

    Have you had contact with someone with a positive diagnosis or presumption COVID-19?

    Have you passed COVID-19 disease?

    If so:
    I have passed the quarantine

    3. DATA PROTECTION