Custom Bouquet Order Form
Houston Based Gothic Florist
Notes to keep in mind: 1. Orders less than a week out require a $30 rush fee. 2. Pickup on weekdays must be after 6pm. 3. I do not currently offer delivery. 4. HALF of your order total is due at the time of ordering. Payment methods on the bottom of this form.
Thank you so much for your support!
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
PICKUP date (NOTE: Orders placed less than 7 DAYS out require a $30 RUSH FEE)
*
-
Month
-
Day
Year
Date
PICKUP Time (NOTE: Orders are not available for pickup before 6pm on weekdays)
*
Hour Minutes
AM
PM
AM/PM Option
What kind of bouquet would you like?
*
Live Flowers
Artificial Flowers
Mix of both
What is your budget? NOTE: Custom bouquets start at $45.
*
What theme or color scheme would you like?
*
ADD ONS $10
Lights 🌌
Eyeballs 👁️
Glitter spray ✨
Themed Cutouts 🥀
Blood Spatter 🩸
Ribbon Message 📝 (4 words max)
Does this bouquet need to be pet friendly? (Ex: Lillies, Eucalyptus, Calla Lillies, Hyacinth are extremely toxic to pets so they would not be included in a bouquet)
*
YES i have pets
NO pets
Please upload any inspo photos
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Any notes or specifications such as flowers to avoid? ⬇️
Venmo & Paypal- @RottenBloomBouquets Zelle & Apple Pay- (979)476 4516
SELECT PAYMENT METHOD (information below) HALF of total is due at the time of ordering. Send payment using information above.
*
Paypal
Venmo
Zelle
Apple Pay
Save
Submit
Should be Empty: