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Pre-Tattoo Questionnaire
Full Name
*
First Name
Last Name
Cell Number
*
-
Area Code
Phone Number
E-mail
*
DOB
*
MM/DD/YYYY
Is this a cover up?
*
Yes
No
Black, Black & Grey, or Color?
*
Black
Black & Grey
Color
Placement of the tattoo.
*
where on body, e.g. forearm, calf, etc.
Approximate size.
*
in inches.
Brief description of tattoo.
*
Please give as much detail as possible, e.g. subject, any dates or lettering, style (linework, script, realism, neotraditional, traditional, dot work etc.).
Reference photos (if applicable).
Browse Files
Please include any reference photos you have. This gives me an idea of what you are interested in.
Cancel
of
Budget:
*
$100-$200
$200-$500
$500-$1000
$1000+
TYPES OF PAYMENT ACCEPTED:
Cash preferred
Credit Card (3% fee will be added)
Are you able to come in sooner for your appointment if an earlier date becomes available? If yes, on which day(s) of the week? (check all that apply)
*
No
Yes - Wednesday
Yes - Thursday
Yes - Friday
Yes - Saturday
Yes - Sunday
Have you ever been tattooed before?
*
Yes
No
Are you pregnant or breastfeeding?
*
Yes
No
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COVID-19 Screening Questions
Please check if you have experienced any of the following in the last 14 days:
*
Cough
Fever
Shortness of Breath
Loss of Smell
Loss of Taste
Flu-like Symptoms
NONE OF THE ABOVE
Have you been in touch with a known of suspected COVID patient or anyone experiencing the above symptoms?
*
Yes
No
Maybe
If Yes or Maybe, please provide a brief description:
e.g. relationship to person, last known contact
COVID-19 GUIDELINES:
You will need to wear a mask during the entire duration of your tattoo session.
No guests are allowed under any circumstances.
You will need to use the shop-provided hand sanitizer OR wash your hands after your temperature is taken upon entry.
Please bring your own water as the dispenser is off-limits to the public.
If you are feeling ill in any capacity, please stay home and contact me to reschedule your appointment.
Do you accept the above-referenced guidelines?
*
Yes - I accept.
No - I do not accept.
Please verify that you are human.
*
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