Tattoo Request Form

Booking for June & July 2026

Pricing: $65 minimum or $85/hr before tax

Announcement:

I am currently pregnant and due in August. I am planning for my last day to be August 1st unless baby decides to make an early arrival. I have yet to decide how long of a maternity leave I will be taking, but I will be coming back part time!

As my belly continues to grow, it is getting harder to tattoo certain placements. I will no longer be taking appointments for ribs, spines, sternums and collarbones for the remainder of this pregnancy.

I am still taking foot/ankle tattoos but you must be comfortable standing on a stool during the stenciling process as I am no longer able to bend over far enough while sitting on the ground.

Name

First NameLast Name

Email Address

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Date of Birth

You must be 18 years old to get a tattoo in the state of Iowa regardless of parental consent. You do not need to be 18 at the time of submitting this form, but you must be on the day of your appointment.

Are you pregnant or nursing? If so, I cannot tattoo you.

Are you booking for yourself or a group session?

If booking for a group session, you only need to fill out one form. Please provide the following information for each person receiving a tattoo: First & Last Name, Email Address, and Date of Birth.

Approximate Tattoo Size

Please estimate size in inches (1-2", 2-3", 3-4", etc.)

Tattoo Placement

(Ex: forearm, upper arm, calf, thigh, etc.) **I am no longer taking rib, spine, sternum or collarbone tattoos for the remainder of my pregnancy.

Black or Colored Ink

If you would like color, please state what color you would like. I only offer color as solid line work or as a pop of color.

Type of Tattoo

Description of tattoo(s)

Please describe with as much detail as you can the tattoo(s) you are wanting to get. If booking for a group, please provide details for each persons tattoo. If requesting birth flowers, please specify the birth flower month and type. If requesting lettering, please specify font type (cursive, typewriter, sans serif, etc.).

Inspiration/Reference Photos

Please upload all of your inspiration photos for each tattoo being requested. You can upload multiple photo to the box above. These photos are typically used as inspiration and do not need to be an exact replica of the tattoo(s) you are wanting to get.

What days and times work best for you for your appointment?

Is there anything else you would like me to know?

Additional Scheduling Requests, Inquiries or Comments

Thank you so much for your interest in getting a tattoo done by me! Please be sure your form is filled out with as detailed as possible as this will allow me to get back to you quicker with a price estimate and appointment times.

Tattoo Request Form

Personal Information

Tattoo Information