Release Form - Folklore Tattoo Omaha

Company

This field is for validation purposes and should be left unchanged.

Tattoo Eligibility

Date of Birth(Required)

Age(Required)

Please enter your birthdate, you must be 18 or older to continue.

Identification / Contact Information

Passport or State Issued ID(Required)

Accepted file types: jpg, png, jpeg, gif, pdf, heic, Max. file size: 8 MB.

Please upload a current photo of your Driver's License, Military ID, State ID, or Passport for age verification.

Client Name(Required)

What are your pronouns?

He/Him

She/Her

They/Them

Prefer not to answer

Phone(Required)

Email(Required)

Join Our Mailing List(Required)

Yes

No thanks

Address(Required)

Health Questionnaire

Medical Conditions(Required)

Do you have any conditions or are you taking any medication that could affect your procedure or healing?

** State law restricts us from tattooing anyone under the influence or is pregnant and/or nursing.

Other Medical Condition(Required)

Please let us know what your condition is.

Medications

Please enter any medications you are taking (Skip if does not apply)

Allergies(Required)

Yes

Do you have any allergies to disclose to your artist?

List your Allergies

Such as: latex, adhesives, lidocaine or other numbing products, other...

Appointment & Tattoo Details

Scheduled Appointment Date(Required)

Your Tattoo Artist(Required)

Guest Artist Name

Simple Description of Your Tattoo(Required)

Specific Location of Your Tattoo on Your Body(Required)

Terms and Conditions(Required)

NO - I haven't read the terms and conditions

YES - I have read and agree to the terms and conditions

I hereby, attest I am at least 18 years old and do not have any physical, mental, or medical impairment or disability, including allergies which might affect my well being as a direct or indirect result of my decision to have any tattoo/piercing related work performed on me. I accept any and all responsibility for any consequences for my decision to have any tattoo/piercing related work, including spelling, numerals, & design. I authorize my tattoo artist to design my body art request via his or her interpretation. I agree to pay for any and all damages or injuries to any and all persons and property resulting from my decision to have any tattoo/piercing related work done by a representative of Folklore Tattoo. I hereby release any and all persons representing Folklore Tattoo from all responsibility, now and in perpetuity. I have also received aftercare instructions for my tattoo/piercing and agree to follow all instructions concerning care while it is healing. I have read and understand the above information. I represent and warrant that the above information is true and correct.

Customer Signature(Required)

Tattoo Release Form

Tattoo Eligibility

Identification / Contact Information

Health Questionnaire

Appointment & Tattoo Details