Removal Form

Consultation Request Form: Removal
Please fill out the form to contact us about removing any unwanted permanent makeup. We will get back to you via email as soon as possible. Thank you!

You can also directly call Fresh Cosmetic Studio at 737-336-7008 for immediate answers.
Full Name*

First NamePreffered Name Last Name
Pronouns
Contact Number*
Please enter a valid phone number.
Email Address*
example@example.com
How did you hear about us?
How old is the tattoo?
Where on your body is it located?
Did you get any unusual reactions when you first received the tattoo?
Check which may currently apply to you:*
Medical history and medications we should know about?:*
What days/times are you available?
Upload a photo of the tattoo you're wanting to remove.

Cancelof
Should be Empty:

Consultation Request Form: Removal