Sammy Bockelman at Mirror Gallery
Appointment Inquiry Form
2025 Intake and waitlist
*Form submission does not guarantee an appointment.
New client or existing Client?
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Name
First Name
Last Name
Email
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Phone Number
Please enter a valid phone number.
Availability
Morning
Afternoon
Any
Unavailable
Monday
Tuesday
Wednesday
Thursday
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Sunday
Tattoo Description. Please provide as much information as possible.
*Please include the style of tattoo desired.
Tattoo placement
(e.g., forehead, right bicep, ring finger on left hand)
Overall dimensions
(e.g., 4x5", size of business card, entire arm onto hand, outer quad, full calf)
Black and grey or color?
Black and grey
Color
Please provide 2-3 high quality reference photos and photos of placement area.
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