INTAKE FORM

1
Name* This field is required.
First Name
Last Name
2
Pronouns
3
Phone Number* This field is required.
Please enter a valid phone number.
4
Email* This field is required.
example@example.com
5
I am 18 years of age or above.* This field is required.A valid license or ID with proof of age may required on day of appointment.
YESNO
6
Placement* This field is required.(sorry no hand or feet tattoos for the time being)
Arms/wrists
legs
back
chest
stomach
neck
buttocks
7
Placement Photo(Only required if area has surrounding tattoo’s and if comfortable with doing so!)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
8
Estimated Size* This field is required.Final cost will depend on final size and length of time the tattoo will take.
1-3 inches
4-6 inches
7-10 inches
10+ inches
9
YOUR IDEA* This field is required.Please note that if your project is chosen, you will be contacted and offered a date to be booked. A NON REFUNDABLE Deposit of $50 is required through Credit Card to book your appointment. Please see Kianajadepmu.com/policies for full info. By booking an appointment you are acknowledging and accepting the policies listed in the link above. ONE redraw will be included in your deposit and the $50 will be deducted from the final total on appointment day. Any additional redraws will come with a fee and a chance of requiring to reschedule. Please be patient and I can't wait to hear all your ideas! PLEASE WRITE AS MUCH DETAIL ABOUT YOUR PIECE AS POSSIBLE. (Pls include notes about reference photos you are attaching as well.)
Huge
Large
Normal
Small
Ok
Ok
10
REFERENCE PHOTOS* This field is required.Please Include at least 2 reference photos.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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11
BudgetPlease only fill this section if you are working within a certain budget, I can do my best to customize your design to fit somewhere within it. Thank you!
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