ೀ Tattoo Request Form ೀ
Thank you for choosing me to be your tattoo artist ᜊ( ´ ˘ `) ੭♡ .𖥔 ݁ ˖ Please take a moment to fill out the required fields below ★For Custom Tattoos: Attach at least three reference images you’d like me to consider during your online consultation. In the description box below describe your tattoo idea in detail ★For Flash Tattoos: Upload a screenshot of the design you’ve selected at the bottom of the page. Once your form is submitted, within 1–3 business days I’ll reach out to you through email from Harajukutattoo@gmail.com with the subject: ₊ ˚ ೀ 𝒯𝒶𝓉𝓉𝑜𝑜 𝑅𝑒𝓆𝓊𝑒𝓈𝓉 ೀ .⁺ to either: ✿ Schedule an online consultation via Google Meet (for custom tattoos), or ✿ Confirm and secure your appointment date.✿ $100 deposit through Zelle/Cashapp is required to secure a booking. $100 deposit goes toward total price.I look forward to meeting you and creating a lovely tattoo for you! ༘⋆✿ -𝒮𝓉𝒶𝓇𝒸𝒾𝓈𝓈𝒶 ✩°。⋆
Full Name
First Name
Last Name
Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
For custom tattoo requests a consultation is required before booking a tattoo appointment date. What date and time work best for you to schedule an online consultation with me?
For Flash tattoos and Custom tattoos which date and time are you wanting to book your tattoo appointment?
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Month
-
Day
Year
Date
Hour Minutes
Date of Birth
*
-
Month
-
Day
Year
Date
Race/Ethnicity
Preferred Pronouns
Are you at least 18 years old or older?
*
Yes
No, I’m 16 -17 and plan on obtaining a signed/notarized parent consent form
What’s your budget?(min starts at $200)
*
Body placement location for tattoo?
*
Skin tone?
*
Fair
Tan
Melanated
Deeply Melanated
Tattoo style?
Kawaii
Sanrio/San-x
Anime
Black/grey
Minimal color
Full color saturation
Pokémon
Creepy cute
Blackwork
Glitter
American traditional
Letters/numbers
Ornamental
Floral
Cosmic
Esoteric
Artist’s choice
Flash design
Other
Allergies? If so please list them. (Latex, adhesives, lavender,etc)
Pregnant?
*
No
Yes (Sorry, you can’t get tattooed rn)
Are you traveling?
*
No
Yes
Bleeding disorder?
No
Yes
Is this your first tattoo?
*
No
Yes
Do you have nerve damage, sciatica, or any chronic pain conditions that may affect the area being tattooed?
No
Yes
Session hourly preference? (More detailed & larger designs will require more time)
*
1 hour $200
2 hours $200-$400
3-4 hours $600-$800
Day sessions 5-7 hours $1000+
Please describe your tattoo idea in detail
*
Upload your image references here. (Please include at least 3 different images for your design)
*
Browse Files
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Do you understand that deposits are required to secure an appointment, non-refundable, and non-transferable?
*
Yes
Submit
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