Tattoo & PMU Request form

Tattoo Request Form

Thank you for your interest in getting a Tattoo or Permanent Makeup service done by me! Please fill out this form and I will contact you via text within 24-48 hours to schedule a free consultation! *Must be 18 years old to get tattooed in North Carolina, No exceptions!
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Type of service *
Please give a detailed description of what you are looking to get and include body placement of tattoo.*
Please list all medical and/or skin conditions (eczema, psoriasis, heart conditions, autoimmune, etc.)**
Are you pregnant or nursing?*
Are you currently using retinol products or have had Botox or fillers within the last 3 weeks in the area looking to get tattooed? *
Please upload any reference images and or tattoo inspo photos here. * If requesting a Permanent Makeup service, please upload a clear photo of your brows or lips with no makeup on the area.*

Cancelof
Consultation Preference *
Are you over the age of 18?*
Should be Empty:

Tattoo Request Form