Survivor Application 2024

Thank you for your courage in reaching out. We deeply appreciate the trust you place in us, and we’re honored to walk alongside you on your healing journey. Your strength inspires us every day, and while we truly wish we could meet every request, there are times when limitations prevent us from doing so.

Important Updates:

We are currently managing requests with a short waiting list, and we sincerely appreciate your patience.

From January 2025 to April 2025, tattoo removals are on a temporary pause. We’ll keep you updated as soon as things change

At this time, we are unable to accommodate large-scale cover-ups or removals.

Our services are made possible through the generous support of community donors and dedicated volunteers. We kindly ask that all interactions with our team remain respectful; not demanding.

If you’re inquiring about our program or training and are located out of state, please email us at ari.careteam@gmail.com, and we will do our best to assist you.

For residential, MDT, or programs outside the Tri-State area that need tattoo services for your clients, please contact us at admin@arionline.org with a referral from your agency.

Every tattoo is screened and scars must be healed up to a year before cover ups

Name*

First NameLast Name

Pronouns*

If you prefer not to disclose, put N/A

Birthdate*

Date

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Can we text you or leave a voice mail?*

TextVoicemailBoth: text & voicemail

Email*

example@example.com

Date of last tattoo session or tattoo removal

Date

Service Needed*

Tattoo Cover-upRemoval

Why are you seeking a cover-up*

Trafficking/Commercial Sexual ExploitationSelf Harm (scars)Gang Affiliation or Hate Group Affiliation (this will be verified)Clear Track Mark Scarring

Location/description of what needs to be covered & how was it obtained?*

Upload an image of the area needing a cover-up or removal (no image/bogus images, or unclear image of the area needing services will not be reviewed)*

Support Services Needed*

Counseling Services & Life Coaching (Zoom Sessions Available)Highschool DiplomaN/A

What gang/hate group is your tattoo affiliated with?*

If gang/hate group affiliated: If you are willing to share, at what age did you become involved in this group? What life circumstances brought you into the life and what encouraged you to exit?*

If you are needing tattoo cover-up - Where was your tattoo received?*

How will this cover-up/removal impact your future?*

How did you hear about Atlanta Redemption Ink (ARI)?*

Are you currently enrolled in a program? If so, would you feel comfortable sharing whether there's an opportunity for your program to help cover the costs of your cover-up or removal? We operate solely on the support of dedicated volunteers and individual community donors, so any collaborative contribution is greatly appreciated. PUT N/A if youre not enrolled in a program*

If you're able, would you consider contributing any amount toward your cover-up or removal? Please know that this is completely optional, and we understand that every healing journey is unique and personal.*

I acknowledge that I personally am taking a step in my own journey by applying. ARI takes the time to carefully screen and match individuals with our partnered shops and removal specialists. I understand that missing appointments, no-shows, or repeated rescheduling, lack of communication may result in delays in receiving services or removed from applying*

Agree

ARI is dedicated to inclusion and respect. We do not discriminate on the basis of race, color, religion, gender, gender expression, age, national origin, disability, marital status, sexual orientation, or military status. We value and welcome the unique contributions of every individual in our community.*

agreed/understand

This program is available for individuals who are unable to afford removals, cover-up services for scars or tattoos. While ARI is committed to offering assistance where there is genuine need, submitting an application does not guarantee services. We will reach out if we are able to provide help, and we respectfully ask that you do not contact us repeatedly for updates or misuse this service. Additionally, please be aware that ARI does not offer full sleeve tattoos or large-scale pieces. For scar cover-ups, the area must be healed for 6 months to 1 year, based on the artist's discretion..*

AGREE/Understand

I agree that everything stated above is correct and I agree to the terms when submitting this application*

AGREE