Salem Slater Tattoo Request Form

Salem Slater Tattoo Request Form
Thank you for your interest in getting tattooed by me! Filling out this form helps streamline the tattoo requests I receive, so please include any information relevant to our session. If you don't receive a response within 1 week of submitting this form, feel free to reach out through my Instagram (@mesmerize.ink) or by email (mesmerizetattoos@gmail.com) for follow-up. Be sure to check your spam and message requests!

Please read below before continuing with this form:

Home Shop Policy (Memento Mori Tattoo Studio in Walkerton, IN)
- Appointments start at 12pm unless requested otherwise.
- Appointment minimum for a session is $100.
- A $100 non-refundable deposit (sent through Cash App/PayPal/Venmo) is required to secure your time. Salem will send you the handles for these to submit payment if your request is accepted. Tattoos are charged at a rate of $100/hr for the appointment duration, but a general quote will be given based on the estimated amount of time your appointment may take. The $100 deposit is deducted from your final cost.
- If your appointment is canceled within 72 hours of the scheduled time, you forfeit the deposit being transferred towards your next scheduled appointment. Before the 72 hour deadline, deposits may only be honored for one rescheduled session. This rescheduled appointment must be confirmed within a week following the cancellation to keep your current deposit.
Personal Information
Preferred Name*

First NameLast Name
Pronouns
She/her, he/him, they/them, etc.
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Social Media
Instagram/Facebook for tagging you in posts!
Tattoo Information
Tattoo Placement, Size*
Location (forearm, calf, etc.), and the approximate size in inches. This information will help Salem design your tattoo.
Tattoo Placement Photo*

Cancelof
Style*
Realism, traditional, illustrative, etc.
Color or B/G*
Color, black and grey, etc.
Reference Photos*

Please describe the elements you like from your reference photos in the description box..
Cancelof
Description of Tattoo*
Any and all details I could need to know! Level of detail, extra style elements, cover-up details, etc.
Scheduling Information
PREFERRED DAYS OF THE WEEK*

MONDAYTUESDAYWEDNESDAYTHURSDAYFRIDAYSATURDAYSUNDAY
PREFERRED TIME OF DAY*

Early (9am-12pm)Afternoon (12pm-3pm)Late (3pm-5pm)
IS THIS YOUR FIRST TATTOO?*

YesNo
HAVE YOU BEEN TATTOOED BY ME BEFORE?*

YesNo
ADDITIONAL COMMENTS
This section is for any last comments, questions, or concerns. If this is our first time meeting, tell me about yourself if you’d like!
Thank you so much for reaching out! I look forward to reading over your request.
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Salem Slater Tattoo Request Form

Personal Information

Tattoo Information

Scheduling Information