Areola Amber Tattoo Request

3D Areola Tattoo Request

Thank you so much for your interest in my work. This form helps me streamline the booking process. If you’re unsure of anything, just fill it out the best you can. I do my best to answer these submissions promptly but it may take several days for me to respond due to volume, your patience and support is greatly appreciated.
Name '*

First NameLast Name
Email*
example@example.com
Phone Number
Not required, I may phone if needed to discuss further.
Location of appointment requested:*

Brussels, Belgium (Nov 12th-17th) 2025Zen Ink - Asheville, NC (Dec 3rd-6th) 2025Earthbound Ink - New Hartford, CT (All other days)
How many months of healing since last surgery in the area*
Photo of area to be tattooed

Cancelof
Description*
Would you like me to fill out paperwork for you to submit for insurance?*

YesNoI’m not sure
Would you like a consultation before booking an appointment?*

Yes - In PersonYes - Zoom CallYes - Phone callNo - I trust the process, let’s book!I’m not sure
PREFERRED DAYS OF THE WEEK*

WEDNSDAYTHURSDAYFRIDAYSATURDAY
PREFERRED BOOKING TIME*

Early (12pm - 3pm)Later (4pm - 7pm)
If you are looking for a specific date, please list below those dates/times, so I can try to accommodate you.
We have some financial assistance available for breast cancer survivors. If you would like to apply for this please just let me know a little about yourself and what this tattoo would mean for you:
Questions? Or, Is there anything else you would like me to know?
Have you been tattooed by me before?*

YesNo
*Please let me know if you are only looking for price estimates and are NOT looking to booking an appointment.*
Should be Empty:

3D Areola Tattoo Request