✶ Community Care Flash Tattoo Inquiry Form ✶

✶ Community Care Flash Tattoo Inquiry Form ✶

Apply for a free flash (pre-designed), palm-sized tattoo. This form is for underserved community members (BIPOC, LGBTQ2S, and disabled/neurodivergent folks) who *cannot otherwise afford this service.* ONE APPLICANT WILL BE CHOSEN MONTHLY, which unfortunately means most applicants are not able to be accommodated. This is in no way personal. Please only apply once every six months.
Full Legal Name*

First NameLast Name
Pronouns and Preferred Name (if different from legal name)
Date of Birth*

MonthDayYear
Date
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Upload a photo of your government-issued identification*

Cancelof
Please note out studio is, unfortunately, up two short staircases and our building does not have elevators or escalators. Clients must be able to climb stairs in order to come into the studio.
Do you have any allergies or medical conditions your artist should be aware of?

0/50
I am not pregnant
I am not currently in any ongoing medical treatment
Emergency Contact Name*
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
YesNo
Please note I do not tattoo ribs, fingers, throats/necks, or genitals.
Did you have a flash design chosen already (viewable on Patreon) or will you choose at our appointment? If you have a placement in mind, please note it here.*
Signature (Please sign to confirm your consent and understanding)*

Powered by Jotform SignClear
Should be Empty: