Full Name
*
First Name
Last Name
E-mail
*
example@example.com
Date of birth
*
-
Month
-
Day
Year
Gender Identity
Please Select
Male
Female
Non-binary
Prefer not to say
Other
What is your skin tone?
*
Please Select
Light/pale
Lightly tanned
Medium
Dark
Are you currently taking ANY medication or do you have a medical condition?
*
Yes, I will provide details below
No
If you answered 'Yes' to the previous question, please provide us an exhaustive list of your medications and/or conditions. This information will be kept private and confidential according to the current GDPR laws.
Have we tattooed you before?
*
Yes
No
Desired artist
*
Please Select
Amia Town Tattoo
Ellie Louise Ink
No preference
Preferred days
*
Tuesdays
Wednesdays
Fridays
Saturdays
Please describe your idea:
*
How big would you like the tattoo to be? Please specify in inches or centimetres.
*
Where on your body do you want the tattoo?
*
What shading would you like for this tattoo?
*
Colour
Black/grey
A combo of the two
Plain linework (no shading)
Please include images that have inspired you!
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