Appointment Request Form

1
Full Name* This field is required.
First Name
Last Name
2
Phone* This field is required.
Area Code
Phone Number
3
E-mail* This field is required.Double check your email! If there are any typos, your submission form will not be reviewed.
example@example.com
4
Are you a returning client? * This field is required.
YESNO
5
Tell me about your tattoo!* This field is required.If youd like to get more than one tattoo please include them all on ONE submission form. PLEASE KEEP YOUR ANSWER CONCISE!!! Any forms submitted without descriptions of what you’re wanting will not be processed.
Tell me a bit about your idea!
Size (in inches)
location on your body
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
6
What kind of tattoo are you interested in receiving?* This field is required.
Flash related design(s)
Custom large scale
Custom small scale
7
**Reference Images Use this section to upload images or screen shots of desired flash. If you are "building your own still life", please circle the specific details you want included. **CUSTOM COMMISSIONS MUST SUBMIT REFERENCE PHOTOS OR THEY WILL NOT BE REVIEWED.**
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
8
What is your general availability?* This field is required.Choose whichever days and times from the options below that best apply. If you are traveling, please choose " im traveling" as your option and you will have the ability to fill in your specific dates later and we will work together to accomodate your travel plans as best as possible, within reason.
Monday 10AM - 2PM
Monday 2PM - 5PM
Thursday 10AM - 2PM
Thursday 2PM - 5PM
Friday 10AM - 2PM
Friday 2PM - 5PM
I’m traveling
Tuesday 11AM - 4:00pm
Wednesday 11AM - 4:00pm
Sunday (limited availability- these spots go fast)
9
Where are you trying to book with me?Click the corresponding location
ATLANTA
BOSTON
NEW YORK CITY
LOS ANGELES
NASHVILLE
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