Name *

First Name

Last Name

Preferred Pronouns

He/Him

She/Her

They/Them

Other

Phone

(###)

###

####

What Days Work Best For You To Get Tattooed? *

I am available to tattoo Tuesdays-Saturdays but can make exceptions if I need to.

Tuesday

Wednesday

Thursday

Friday

Saturday

Do You Have Reference Photos? *

This better helps me get a visual idea of what you want.

Yes

No

Is This A Coverup? *

Yes

No

Are You Over The Age Of 18? *

If not, your parent/legal guardian must be present and must be there to fill out the proper paperwork for you. I will only tattoo as young as 16, NO EXCEPTIONS.

Yes

No

Is This A Touchup For A Tattoo Done By Me? *

I offer FREE touchups to all my work

Yes

No

I Understand That There Is A REQUIRED Deposit To Book An Appointment. *

Deposits are NON REFUNDABLE, please refer to the FAQs for more info.

Yes, I Understand.