Tattoo Inquiry Form

Name*

First NameLast Name

Age*

Birth Date

Date

Phone Number*

Email*

example@example.com

Previous client?*

YesNo

Reference Image 1*

Reference Image 2

Reference Image 3

State the exact design placement and size. (Example: “Left forearm, outer side. 5-7 inches”)

Select a budget range. ($100 minimum for small tattoos)*

I understand that receiving a tattoo results in a permanent change to my skin and body.(Required)*

I understand that this procedure is a permanent change to my skin and body.

I acknowledge that Erial does not offer refunds under any circumstances.(Required)*

I understand that Erial is unable to determine whether I have allergies or sensitivities to any products, inks, or materials used during the tattoo process.(Required)*

I acknowledge that Erial does not offer refunds.

I understand that I am responsible for properly caring for my tattoo by following the aftercare instructions provided by Erial.(Required)*

I agree that Erial does not have a way of identifying if I am allergic to the elements or ingredients that will be used for my tattoo.

I acknowledge that failure to follow aftercare instructions may result in complications, including but not limited to irritation or infection.(Required)*

I understand that I need to take care of the tattoo by following the instructions given to me by Erial.

I confirm that all information I have provided in this form is accurate, complete, and truthful to the best of my knowledge.(Required)*

I understand that I might get an infection if I don't follow the instructions given to me in regards of taking care of my tattoo.

I confirm that the information I provided in this document is accurate and true.

Preferred Appointment Date (THIS DOES NOT CONFIRM YOUR APPOINTMENT.)*

You will receive an email within 24 to 48 business hours with details on appointment availability and finalizing your desired appointment date/time. All appointments require a $100 deposit via Apple Pay, zelle, or Venmo. Your deposit is deducted from your total on the day of your appointment. Deposit instructions are sent out after an agreed-upon appointment slot. Cancellations within 48 hours forfeit their original deposit. No calls/no-shows forfeit their deposits. One reschedule is allowed if it is requested at least 2 days before your appointment.

Tattoo Inquiry Form

Client Information