Fine line tattoo
(custom design)
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Date of Birth (must be 18+) please bring ID on the day of your appointment.
-
Month
-
Day
Year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please include as much detail as possible about your desired tattoo, including placement and size.
Please include detailed reference photos. For flash designs please include which design/s you would like.
Browse Files
Drag and drop files here
Choose a file
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of
Preferred day
Monday
Wednesday
Thursday
Friday
Saturday
After hours
Please select if any of the following may apply to you
Skin irritations, such as eczema, psoriasis, chronic dermatitis, acne, open skin or wounds in the area to be tattooed.
Diabetes
Heart concerns
Allergies including latex
Blood disorders
Pregnancy/breastfeeding
Problems with healing
Prone to keloid scaring
Currently undergoing chemo or radiation therapy
Currently taking acne medications
Hepatitis
Immune system disorders (HIV, lupus ect)
Please list medications
Please list allergies
I understand that I am responsible for the “at home after care” which may have risk of infection or fading of pigments if not carried out fully.I consent to before and after photos of this procedure. I have had the opportunity to ask questions relating to this treatment, and am aware that more than 1 treatment may be necessary for best results. Complimentary touch ups at 4 weeks are available if required.I understand that there are no refunds given.
I understand
Signature
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