Tattoo Request-Cory Phillips
Please use this form to inquire about your tattoo with Cory Phillips at Third Earth Studios. One tattoo request per client only please. Understand at this time that we are undergoing high request rates for appointments and it may take some time to process your tattoo Inquiry. Cory is a completely custom artist and reserves the right deny or redirect your request. Further information and questions can be also directed to donna@thirdearthstudios.com
Name (Does NOT have to be your legal name. Just what you would like us to call you)
*
First Name
Last Name
Pronouns
She/her
He/him
They/them
Other
Email
*
example@example.com
Phone Number
*
Not required, I may phone if needed to discuss further.
Format: (000) 000-0000.
Do you give us permission to text you regarding appointments information and updates? There will be absolutely no spam or promotional texts.
*
Yes
No
What location are you looking to be tattooed at?
*
Home studio, Third Earth Studios
Convention
Guest Spot
Please give a short description of the tattoo you are inquiring about
*
Placement
*
(forearm, calf, etc. Specify left or right also please)
Is this a coverup?
*
Yes
No
Please attach a clear forward facing photo of the area of your body where the tattoo will be placed. NO MIRROR SELFIES PLEASE! You may skip this question if you are not comfortable or unable send a photo.
Browse Files
Drag and drop files here
Choose a file
For cover ups, your photo should include a full image of the tattoo or scar that you would like to cover and the area around it.
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Color or Black/grey?
*
Color
Black/grey
Reference 1 (NO AI IMAGERY PLEASE)
Browse Files
Drag and drop files here
Choose a file
Up to 3 references are allowed on this form. Other references can be brought to your consultation or emailed.
Cancel
of
Reference 2 (NO AI IMAGERY PLEASE)
Browse Files
Drag and drop files here
Choose a file
Up to 3 references are allowed on this form. Other references can be brought to your consultation or emailed.
Cancel
of
What is your maximum budget for your tattoo?
Are you able to attend an in person consultation? It is okay to select no if you are unable or traveling and we will accommodate!
Yes
No
Your basic availability. In most cases an initial consultation appointment will be given to you based off your availability and you will be able to change it if need be.
*
Rows
Between 11am-3pm
3pm or later
Anytime
Not Available
Tuesday
Wednesday
Thursday
Friday
Saturday
If you are looking for a specific date or time frame? Please list below so I can try to accommodate you.
Skip if this doesn’t apply. Disability Accommodations: We strive at our studio to provide an accessible and comfortable experience to all people including those with disabilities both physical or neurological. Please let us know of any accommodations we can provide that would help you during the tattoo process. We have listed some general accommodations and the next section will give you a place to enter additional that aren’t listed. (We DO NOT require proof or explanation of a disability)
Wheelchair use and accessibility
Limited or Specific positioning during the tattoo process
Silent/limited Talking/ Low Noise Appointment
Shade from fluorescent lighting
If there are other accommodations you need that aren’t listed above or if you have questions, you may list them here.
Have you been tattooed by CORY PHILLIPS before?
Yes
No
How did you hear about Third Earth Studios or Cory Phillips before?
ADDITIONAL QUESTIONS OR COMMENTS
Please understand that we require a $100 non-refundable deposit to schedule all tattoo appointments (not including consultation appointments) The deposit comes off the price of your tattoo once complete. Failure to show or rescheduling without 48hr notice will forfeit the deposit and require another full deposit to reschedule. Please sign to state that you understand and agree.
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