TATTOO REQUEST FORM

Tattoo Request!
In order to help me streamline the booking process please fill out any relevent information I may need for your appointment below. If there is a question you do not understand or are not sure how to answer, give a best guess and let me know at the end how I can help.

*Please note that all tattoos will be done in my own style*
Preferred Name*

First NameLast Name
Email*
example@example.com
Phone number *
(Used for reminders for your appointment)
Do you have any blood borne illnesses?*

YesNo
If so please list which one
This does not determine whether or not you can get a tattoo. This information is used for safety precautions, and to determine the best way for you to heal your tattoo.
Placement*
(forearm, calf, etc. Be specific.)
Is this a cover-up*

YesNo
Placement Location
If there is a cover-up involved, please take a well-lit photo of the tattoo or scar that you would like covered as well as some area around it. Also please note how old the tattoo/scar is in the description box.
Tattoo Size*
Please guess size in cm or inches
Colour or B/G*
Colour, black and grey, or some mix, let me know
Description*
Any and all details I could need to know
Budget If you have one
REFERENCE 1*

Browse Files

Cancelof
REFERENCE 2*

Browse Files

Cancelof
REFERENCE 3

Browse Files

Cancelof
PREFERRED DAYS OF THE WEEK*

MONDAYTUESDAYWEDNESDAYTHURSDAYFRIDAYSATURDAY
PREFERRED TIME OF DAY*

Early (9am-11am)Afternoon (12pm-2pmLate (3pm-5pm)
Specific date if you are looking for looking for one

MonthDayYear
Date
INQUIRIES & ADDITIONAL COMMENTS
HAVE YOU BEEN TATTOOED BY ME BEFORE?

YesNo
Thank you so much for your interest in my work! Please note that at this time bookings are extremely limited and I may not be able to accommodate your request for awhile, but I will try my best! Please allow 7 days for me to respond to your request!

*Black work/dark art tattoos take priority*
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Tattoo Request!