Today's Date: *

MM

DD

YYYY

Please verify that this consult request is for yourself: *

Yes

If it is not, please stop and have the person requesting this tattoo fill out the form with their own information.

Name *

First Name

Last Name

Cell Phone *

(###)

###

####

Verify Cell Phone *

(###)

###

####

You are 18 years of age or older *

Yes

No

Are you looking to do Color or Black and Grey? *

Color

Black and Grey

What tattoo art style are you interested in? *

New School

Traditional

Neo-traditional

Realistic

Hyper Realistic

Photo Replication

Abstract

Free Style

Bio-mechanical

Bio-organic

Other

You have read through the booking information provided on this website *

Yes

No

You have read through the appointment and deposit information provided on this website *

Yes

No

You have read the aftercare instructions provided on this website *

Yes

No

You understand that more information and photo references will be requested after you submit your consult request. This will be sent to the email you have provided *

Yes

No

You understand that all tattoos regardless of size will require a scheduled appointment *

Yes

No

You understand that there can be up to a 2 week delay between each messages due to my available free time in between current appointments *

Yes

No

Please check your SPAM folder in your email especially if you do not see a response within 2 weeks as some clients have been experiencing this issue *

Okay I will be sure to check my Spam folder if I do not see a timely response

I won't check anything and will just think you don't want to tattoo me (lol)

Consult call backs are typically done on Tuesdays and can potentially take up to an hour. What time(s) are you normally available and reasonably free from distractions? Check all that apply *

I'm not available on Tuesdays

12pm-1pm

1pm-2pm

2pm-3pm

3pm-4pm

4pm-5pm

5pm-6pm

6pm-7pm

You understand that appointments may not be available for a few weeks to a few months from the date of this submission

Yes

No

Please understand that tattooing is part art and part science. Your satisfaction as well as my reputation and safety are the #1 priorities. However, I do reserve the right to decline a tattoo proposal for moral, personal, professional and artistic reasons. *

yes