Roots Esthetics Tattoo Request Form

Tattoo Request Form

SERIOUS INQUIRIES ONLY* please complete this form in its entirety. //: edit— the cutoff for requests bigger than 3 inches/7.5 cm is NOVEMBER 8th, 2025!
Full Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
This is how I will contact you. Please make sure it’s correct.
Age as of your appt. *
(must be 18 years or older in the state of WA)
How did you hear about Roots Esthetics?*

InstagramFacebookGoogleYelpFriendOther
If selected “Friend” or “Other”, please provide a name or more information below:
*referral perks range from 10-20% off select services for the person who shared us with you :)
What type of tattoo are you requesting?*

FLASH designCustom design
Design Size*
I only offer up to 4 inches maximum
Design Description*
The more specific the better! i.e. “xx” in x font, flower bouquet with xx flowers with no foliage, FLASH from Geek Sheet “No Face”, etc.
Design placement*
i.e. left forearm, right butt cheek, etc.
***FINGER, HAND, & FOOT PLACEMENTS***

Due to my line-style, tattoos are prone to fade in these areas. This happens because of frequent hand-washing, the lower feet tend to sweat a lot, and in general from the use of your limbs (I call them "high-traffic areas"). You will likely need touch-ups hence will be charged for touchups in the future.
Reference 1*

Cancelof
Reference 2

Cancelof
Reference 3

Cancelof
Appointment Preference (we’ll do our best to accommodate)*
If we cannot accommodate the date above, which days below are you most available? Check all applicable days.

SundayMondayFridaySaturday
Preference for time of day?

Morning - 10am to 11am startAfternoon - 12pm to 2pm startEarly evening - 3pm to 5pm start
Any other access needs or allergies
i.e. shellfish allergies, lighting/noise level adjustments, prefer not to talk, experiencing body pain, low energy, trauma triggers, availability is limited, etc.
Thanks for trusting me to be your next artist (*´∀`)♪

Please allow me up to THREE days to respond. A $50 non-refundable deposit is required to book (please have it ready) and keep in mind that all tattoos are subject to tax.
Deposits are preferable via Zelle or Apple Pay. PayPal and Venmo subjected to transaction fee.
Should be Empty:

Tattoo Request Form

Thanks for trusting me to be your next artist (*´∀`)♪