Appointment Request Form

Appointment Request Form

Chaotic Tattoo
Please read before filling out my form.

Please complete this short form to share your design ideas, size, placement, and any specific elements you have in mind. I require a $70 booking deposit. I don't hold slots until the deposit has been paid. My hourly rate is $120, and I will provide a quote based on how long I estimate the tattoo will take. Please keep in mind, this is an ESTIMATE ONLY, the cost could be less or more, so be prepared to have more money just in case. Once submitted, I'll reach out to schedule a free 15 minute (or less) video consultation before booking your appointment. The invoice will cancel automatically after 48 hours. Looking forward to creating something awesome together!
Full Name*

First NameLast Name
What are your pronouns?*
IG handle
Have I tattooed you before?*
Contact Number*
Please enter a valid phone number.
Email Address*
example@example.com
What days work best for you?*

SundayMondayTuesdayWednesdayThursdayFridaySaturday
What times work best for you? *Please select all the times you are available* For bigger projects, I recommend an earlier time slot!*

10AM11AM12PM1PM2PM3PM4PM5PM
What date and time work best for you?
Any other specific date and time, if the above selection is not suitable.

MonthDayYear
Date
Hour MinutesAM/PM Option
Please provide a detailed description of your idea/ideas or the flash piece you want to get. *
Placement of the area you want the tattoo on?*
Please upload a front facing, clear photo of the area you want the tattoo on. Have someone else take a photo of the area, bad photos will result in no response.*

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How big in inches (Please give an exact dimension for the design. Measure the area with a ruler.)*
Color or black & grey?*

ColorBlack & greyUnsure yet
What's your budget?*
Please upload refence photos of your inspiration for the piece. Try to use photography, moodboards or photos of my work.*

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Further concerns/accommodations
Should be Empty: