Nixx Tattoo Removal

Tattoo Removal Inquiry

Hello, please answer the questions below to the best of your ability. For the best results, the more information we have going into your appointment the better. We look forward to working with you.

Thank you.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
How old is the tattoo you want to get removed?*
What is the size of the tattoo you want to get removed? (inches)*
Where on the body is the tattoo you want removed?*
Have you had any previous laser treatments on the tattoo you want removed?*

YesNo
If "yes" when was your previous treatment?
What is your skin type? (color/ethnicity)
This information helps to ascertain appropriate picosure settings for your skin and the number of treatments you could need.
Please upload clear image(s) of the tattoo you want to get removed.
Image of tattoo you are wanting removed.

Cancelof
Are you looking to get this tattoo faded for a cover up tattoo or removed as much as possible?

RemovedFaded for cover up tattoo
Are you aware if your tattooer used any white ink in the tattoo you want removed, as highlights or in the color?*

YesNoUnsure
Are you planning to go on Accutane or have been on Accutane within the last 6 months?

YesNO
What days are you available for tattoo laser removal appointments?

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Do you have a preferred laser technician to work with?

CraigJennyLaurelNo preference
Please let us know if you have any questions or concerns. As well as any other information you may feel relevant to the tattoo laser procedure.
Thank you for taking the time to fill out this form thoroughly. It will surely help to streamline the appointment process. We will get back to you As soon as possible, and look forward to welcoming you to the studio.

Sincerely,

Nixx Laser Tattoo Removal Team
Please verify that you are human*
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