Lucy - inquiry form

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In compliance with the Rules And Regulations - Body Art for the State of Georgia as of 10/06/2023, please consult a physician for the following conditions BEFORE booking a tattoo appointment with any artist from Worthwhile Tattoo Co.

Excerpt from Chapter 511-3-8-.08 "Client Files"

[YES] answers to the questions below may increase health risks associated with receiving a body art procedure and may require written permission from a healthcare provider to undergo a tattoo procedure.

(a) History of diabetes or any disorder or medication that affects the neurological or immune system in fighting infection; (b) Bloodborne conditions such as Hepatitis B, Hepatitis C, HIV; (c) History of hemophilia or any other blood clotting abnormalities; (d) History of skin disease, skin lesions, or skin sensitivities to soap, disinfectants, etc.; (e) History of allergies or adverse reactions to pigments, dyes, or other skin sensitivities; (f) History of epilepsy, seizures, fainting or narcolepsy; (g) The taking of medications such as aspirin or other anticoagulants (such as warfarin, Xarelto™, Plavix, Eliquis™, etc.) which thin the blood and or interfere with blood clotting; (h) History of or suspicion of adverse reaction to latex or products containing latex; and (i) History of keloid formation. (j) If the client is pregnant or has been pregnant in the last three (3) months.

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Name* This field is required.Please provide YOUR legal name. We require a deposit to book and need to make sure it is filed correctly.

First Name

Last Name

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Preferred name

4

Email* This field is required.Please double-check spelling. We use email to book and send deposit link.

DO NOT use someone else’s email.

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Phone Number* This field is required.Save our shop number so you know when we are calling! 770-489-1699

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Availability* This field is required.

Please include days and times available.

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Have you been tattooed by Lucy before?* This field is required.

YESNO

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Budget* This field is required.What is your budget for this tattoo?

Please note that the minimum is $100, and Lucy's hourly rate is $125 an hour

9

What style of tattoo are you looking for?* This field is required.

American Traditional/ Classic Americana

Geometric / Mandala / Tribal

Floral

Illustrative

Blackwork

I'm not sure

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If your tattoo includes words or a quote, please type exact text below. ie "RIP Nana 1950-2018" NOT "I want my grandmas name with dates"

type NA if no text

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Tattoo location* This field is required.Be specific, please! ie "Upper/outer right arm" NOT "arm"

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Size* This field is required.Size is used to estimate timing/cost. Sizing that does not make sense cannot be scheduled and will be referred to consultation.

Approximate WIDTH in inches

Approximate HEIGHT in inches

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Color* This field is required.

Black and Gray only

Color

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Attach Reference Images * This field is required.Reference images can be tattoos, art, photo, and/or a drawing/mock up you created to help relay your concept.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

Browse Files

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Tattoo Concept* This field is required.Use this space to describe the desired appearance/look of your tattoo. Please only describe visual details rather than the meaning/sentiment.

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Photo of area where you want your tattoo* This field is required.Please take photo in indirect natural light such as by a window.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

Browse Files