Client Intake Form
Share your contact details, appointment preferences, and tattoo goals.
Full Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Preferred Method of Contact
Phone
Email
Text Message
Do you want a payment plan?
*
Yes
No
Payment Amount
*
60% Deposit
Are you wanting a tattoo session or a photography session?
*
Tattoo Session
Photography Session
Does the client have a specific location they want it in, or do they want the photographer to choose?
Specific location
Photographer to choose
What kind of photos do you want done?
Do you have any allergies?
*
Yes
No
If yes, please list your allergies
Are you currently taking any medications?
*
Yes
No
If yes, please list your medications
Do you have any medical conditions we should be aware of?
*
Yes
No
If yes, please specify
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Describe the Tattoo You Want
*
Reference Photo
Upload Reference Photo
Drag and drop files here
Choose a file
Cancel
of
Placement Photo
Upload Placement Photo
Drag and drop files here
Choose a file
Cancel
of
Are you a minor?
*
Yes
No
Guardian
First Name
Last Name
Client's Driver's License
Upload Driver's License
Drag and drop files here
Choose a file
Cancel
of
Guardian or Parent's Driver's License
Upload Driver's License
Drag and drop files here
Choose a file
Cancel
of
Guardian or Parent Consent
*
Guardian or parent signature
Preferred Date or Time of the Appointment
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Submit
Should be Empty: