Appointment Request Form

Appointment Request Form
Full Name*

First NameLast Name
Preferred/nickname
Preferred pronouns
Age*
Contact Number*
Please enter a valid phone number.
Email Address*
example@example.com
How would you prefer to be contacted?*
Tattoo Information

Description and placement
Please write a brief description of your tattoo*
If it’s from a flash sheet, write “flash” and a screenshot of the piece you wanted
Reference Pictures

Please input 1-3 reference photos if any
Please add a reference image
Please add a reference image
Please add a reference image
Where would you like to put this tattoo?*
Ex: left calf, right forearm
Please input an approximate size you would like your tattoo to be (in inches)*
Placement Pictures

Please insert 1-3 images of the area you wanted to place the tattoo. Please include at least one picture with a noticeable object (ex: quarter, pen) so I can estimate the size of the area
Please add an image of the area
Please add an image of the area
Please add an image of the area
Do you have any other information I should know about your tattoo?
If not, leave blank
Booking Information
Which day of the week works best for you?*

MondayTuesdayWednesday
Do you have times that work best for you?
If not, leave blank
Do you have a budget you’re trying to stay in?
If not, leave blank
Do you have any other information I should know about booking your appointment?
If not, leave blank
Extra Information
Do you have any allergies?*
Ex: adhesives, latex
Do you have my medical conditions?*
Ex: diabetes, hemophilia
Do you have any other information I should know about you or your health?
If not, leave blank

Appointment Request Form

Tattoo Information

Reference Pictures

Placement Pictures

Booking Information

Extra Information