Appointment Request Form

Appointment Request

PLEASE READ CAREFULLY BEFORE BOOKING
DESIGN

Use the form below to describe the tattoo you want to get in as much detail as possible. If needed please attach any refernces that represent the idea or style that you are looking to have done or that the tattoo is being based off of. Design for the tattoo will not be sent before appointment. Any small changes will be made the day of if needed. If you are choosing from my flash then just specify and we can go through designs day of.

DEPOSIT

A non refundable $100 deposit will be needed to book the appointment. The deposit amount comes off the final price of the tattoo and simply holds the date and time for you. Payment information is at the bottom of this form.

RESCHEDULING

Deposits will be forfeited with no less than 72 hours notice of rescheduling. If deposit is forfeited a new deposit will be made to make a future appointment.

*IMPORTANT*

You must be at least 18 years of age to get tattooed.

Please be on time to your appointment and come alone. If you are feeling ill please contact me to reschedule.
Full Name *

First Name Last Name
What is your pronoun?
not a required field
E-mail *
Phone

Area Code Phone Number
Describe the tattoo in as much detail as possible *
Sizing (in inches)
Attach reference images (limit 5)

Browse Files

Cancel of
Attach photo of where the tattoo is going. (are we working around other tattoos or filling a unique spot,etc)

Browse Files

Cancel of
Budget *
Any specific date?

Month Day Year
What days work best for you?

Monday Wednesday Thursday Friday Saturday
What time works best for you?

Morning Afternoon Evening
- OR-

My Products

DEPOSIT $ 100.00

Total $ 0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

Should be Empty: