Name
First Name
Last Name
Miranda Boire Tattoo Request Form
If your request is approved, a response will be sent within 2 weeks.
Email
example@example.com
Phone Number
Please enter a valid phone number.
City
Age
Do you have any scars or pre-existing tattoos in the area?
Location of Desired Tattoo
Desired size of tattoo in inches
Skin or blood conditions that may effect tattooing process, i.e diabetes, eczema etc
Black/grey, colour or both?
Realistic, illustrative or image reproduction?
Brief description of desired tattoo
Picture of your body where you want to be tattooed
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Relevant reference photos, illustrating the style you request
Browse Files
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of
Submit
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