Prick and Poke Tattoo Request Form

In order to help me streamline the booking process please fill out any relevent information I may need for your appointment below. If there is a question you do not understand or are not sure how to answer, give a best guess and let me know at the end how I can help.

Which state

Preferred Name

First NameLast Name

Email

example@example.com

Phone number

You may receive text for confirmation

Placement

(forearm, calf, etc. Be specific.)

Is this a cover-up

If there is a cover-up involved, please take a well-lit photo of the tattoo or scar that you would like covered as well as some area around it. Also please note how old the tattoo/scar is in the description box.

Tattoo Size

Please guess size in cm or inches

Style

Realism, neotraditional, linework, etc.

Color or B/G

Color, black and grey, or some mix, let me know

Description

Any and all details I could need to know

Please include a picture of placement location

Browse Files

Please include any reference images

Browse Files

PREFERRED DAYS OF THE WEEK

PREFERRED TIME OF DAY

INQUIRIES & ADDITIONAL COMMENTS

HAVE YOU BEEN TATTOOED BY ME BEFORE?

BUDGET

Thank you so much for your interest in my work! Please note that at this time bookings are extremely limited in order allow our shop to operate as safely as possible so I may not be able to accommodate your request for awhile but I will try my best.

Once I am able to confirm your time and date, you will be asked to put down a $50 depost to hold your place. This depost does go towards your final cost of the tattoo. Further instructions will be included at that time.

For Oregon and Washington Clients: The State does not allow anyone under the age of 18 to receive a tattoo. Even with parental consent.

Tattoo Request!