Tattoo and Paramedical Tattoo Consultation Form
Please fill out the information below
Which Artist are you wanting to book in with?
Jennifer
Amanda
Any Artist Available
Name
First Name
Last Name
Pronouns(Optional):
She/Her
He/Him
They/Them
Other
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
How did you hear about us?
Which City/Town do you live in?
BE ADVISED: We cannot tattoo under 18, EVEN WITH CONSENT! Are you 18 and over?
yes
no
Are you pregnant or breast feeding?
Yes
No
Is this your first tattoo?
Yes!
No!
What is your skin tone - Fitzpatrick scale (you can google this to check as well)
1 light pale/fair
2 light fair
3 medium to olive
4 olive to mid brown
5 brown to dark brown
6 very dark brown to black
Are you prone to keloid scarring
No
Yes
Do you require special assistance during your appointment?
Wheelchair
Walker
Hearing assistance
Visual assistance
Other
For Tattoos Inquiries Only
keep scrolling down if inquiring about Paramedical/Medical Tattoo
What size of tattoo
Small 1-2 inches
Medium 3-5 inches
Large 5 inches +
Open to options/consult
What is your preference for tattoo linework?
Thin fine lines
Thicker lines
Anything/Open
Would you like your tattoo to be all black or with colour?
Black/Greyscale
Colour
Please describe the desired area you would like tattoo:
Example. Upper arm, top of foot, lower inner arms etc.
Please describe the tattoo you desire! The more info you include the better! Thank you.
Example: medium sized red rose
Please include images or photo inspiration of your desired tattoo!
Browse Files
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For Paramedical/Medical Or Scar Camouflage Tattoo Only
If only inquiring about tattoos you do not need to fill this out.
Where is the scar, stretch mark etc. located on your face or body?
How old is the scar, stretch mark, acne scar etc being treated?
What was the cause of the scar, stretch mark, acne scar etc?
We understand this may be sensitive information to share. Please share the amount of information you are comfortable with.
Do you currently have a suntan on the area being treated?
yes
no
Is the area (scar) bring treated
Still pink in colour
Purple/blue tone
Light/Silver (lighter than your natural skin tone)
Darker than your natural skin tone
If the area (scar) being treated
Raised
Indented
Smooth to your natural skin
Paramedical/Medical Scar Camouflage Tattoo - please include multiple clear images of the area you wish to have treated
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
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