Tattoo Request Form

Thank you for choosing Electric Street Tattoo!

Let us get to know you, please provide your contact info below:
Your Name*

First NameLast Name
Email*
example@example.com
Your Number
We'll never call you, not required.
Age Group*

18-2525-4040+
Please provide details about the tattoo you want.

Please fill out any relevant information we may need for your tattoo appointment today. If there are any questions you do not understand or are unsure how to answer, guesses are always welcomed. Let us know at the end how we can help.
Tattoo Style*

Classic AmericanaLineworkNew SchoolPortraitureBlack & GreyNeotraditionalRealismOther
Placement of your New Tattoo*
Be specific: right forearm, lower left calf, upper center back, etc.
Tattoo Size*

Small (less than 3 inches)Medium (3-6 inches)Large (6-12 inches)HUGE (Chest Eagle)
Tattoo Color*

Full ColorBlack & GreyMixedOther
Tattoo Description
American Eagle on my chest; Heart with my mother's name; Please explain in lenght...
Tattoo References

Browse Files
Want to share a tattoo you saw on Social Media? Please upload here. Cancelof
Is this New Tattoo cover-up to a current Tattoo or scar?

YesNo
PLEASE NOTE: If there is a cover-up involved, please provide a well-lit photo of the tattoo or scar that you would like covered including the area around it.
How old is this Tattoo/scar?
Please provide a photo of the current Tattooed area to be covered:

Browse Files
The artist will need this level of detail to work into their new drawing, this ensured the previous tattoo is completely covered. Cancelof
Let's set up your tattoo appointment.

Please note that all daily bookings are limited in order for our artists to provide their Best-In-Class tattoo service.
Are you a returning client?*

YesNo
During the week, when are you best available?*

WeekdayWeekend
During the day, when are you best available?*

DaytimeEveningBoth
Your preferred day of the week?*

WednesdayThursdayFridaySaturdaySunday
Additional questions, inquiries and/or comments for the Shop:

Let us know if there is anything else we need to take into considration while you are here. If you are traveling, need a private consultation, have specific needs, whatever it is, we will do our best to accomodate you!
Let us know your thoughts...
For example: Hello, I need a private room for an intimate tattoo area I would like to have done...
Thank You!
Should be Empty:

Thank you for choosing Electric Street Tattoo!

Please provide details about the tattoo you want.

Let's set up your tattoo appointment.

Additional questions, inquiries and/or comments for the Shop:

Thank You!