Michelle's PDX Custom Tattoo Request Form

Please read Michelle's FAQs prior to filling out this form.

Custom tattoos will be priced at $200/hr and require a $100 non-refundable deposit for each session 3 hours or less. Half day and Full day sessions will require a $200 non-refundable deposit.

Booking priority will be given to floral, nature based and botanical designs. Please note Michelle DOES NOT offer hand tattoos, script or tattoos from the neck up.

Due to extra COVID precautions, Michelle is requiring all clients be Vaccinated, boosted, and wear a KN95 or similar mask at your appointment. Proof of Vaccination will be required at check in for your session.

*Please remember to include reference photos, your proposal will be denied without photos.

If you are looking to book a touch up or finish a previously started tattoo by Michelle, please do not fill out this form. Email us directly with a brief description of the project we are working on, where it is on the body, and how long of a session you would like to sit for at: moderngoddesspdx@gmail.com

Preferred Name*

First NameLast Name

Pronouns: Check all that apply

She/HerThey/ThemHe/HimOther

Email*

Please double check, I will not be able to contact you without a correct email address.

Phone number

Not required

Birthdate*

It is Illegal in the state of Oregon to tattoo anyone under the age of 18 years old. Your government issued photo ID is required at check-in.

Covid Precautions:

Masks are mandatory while getting tattooed with Michelle.

Michelle requires all clients be fully vaccinated and boosted to receive a tattoo and must provide proof of vaccination when checking in for appointments.

At this time, we do not allow guests into the studio, unless assistance is required for a health condition.

As always, please let us know immediately if you are uncomfortable for any reason.

Are you or will you be fully vaccinated and boosted for COVID 19 by the time of your appointment?*

YesNo

Have you been tattooed by Michelle before?*

Yes (thank you!)No (welcome!)

Tattoo Size

Please estimate size in inches.

Tattoo Style - Check all that Apply. *Please note, we do not offer script

Is this piece a scar coverup?

Please note scars must be healed a minimum of 3 years to tattoo over safely.

Tattoo Description*

Be as thorough as possible with your tattoo description, but please limit personal details. Attach reference photos below.

REFERENCE 1*

Browse Files

REFERENCE 2*

Browse Files

REFERENCE 3

Browse Files

Desired Placement*

Please give top 2 choices (Be specific: i.e. right forearm, left calf, etc. ) Please note Michelle is not currently offering tattoos above the neck or on the hands.

Are there any other tattoos in the area?

If yes, please be prepared to share a photo of desired placement and the surrounding pieces.

Desired Placement Photo

Browse Files

Privacy Note: This is not required. These photos will be visible to both Michelle and their assistant. Please only submit what you feel comfortable with.

INQUIRIES & ADDITIONAL COMMENTS

Please include any questions you have about the process, or any notes on how to make your experience more comfortable in shop. I am happy to provide quiet sessions upon request.

Thank you for requesting to work with Michelle. If your proposal is accepted, you will recieve an email within the next two weeks. Please be prepared to put down your deposit within 72 hours of your project acceptance. We look forward to working with you!

Tattoo Request Form for Michelle Pomerantz