THIS FORM IS FOR CUSTOM REQUESTS ONLY
+ it may take up to 10 days for me to get back to you. + i do not do discounted work for custom requests. + please read my FAQ before filling out this form (you can find it on my website dinapsihou.com). + this form is for custom requests - if you would like to book a flash design you can find the form on my website.
name
*
First Name
Last Name
phone number
*
-
Area Code
Phone Number
pronouns
date of birth
*
Please select a month
January
February
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Please select a day
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Day
Please select a year
2026
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Year
e-mail (please check for typos!)
*
example@example.com
is this your first tattoo?
yes
no
what time(s) work best for you?
*
wednesdays @ 11:30am
thursdays @ 11:30am
fridays @ 2:00pm
saturdays @ 11:30am
sundays @ 11:30am
please use this section to list any specific dates you are unavailable or out of town, or to list specific dates you are visiting and available.
type of appointment
*
flash piece
custom piece
if you have a budget, please let me know below. please name your budget PER SESSION (in most cases symmetrical tattoos or larger pieces take two sessions)
if you are able to pay full price for a tattoo, please respect my time and do not use this option. this is for people who absolutely cannot save up to pay full price for a tattoo. thanks!
placement? please be specific! **i do not tattoo SIDE OF RIBS or INNER BICEPS (or cover ups)**
*
size? (in inches)
*
please describe your custom idea below! be as specific as possible :)
*
reference photos help a lot, so if you have any, please upload them here!
browse files
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of
if you have any questions, comments, concerns please leave them here!
i understand that i will need to send a $100 deposit to book this appointment and that i will receive the information on where to send it after dina and i have agreed on an appointment date!
*
yes!
Submit
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