Name:

Email:

Phone Number:

Age:

Where do you live?

Are you over 18 and can provide a valid form of ID?

Are you a repeat client?

Do you have a preference on which artist you want to work with?

Where do you live?

Out of town folks: Please list the dates you will be in town for.

Size:

Placement: List multiple locations if unsure.

What is your desired tattoo?

Do you want color, grey/wash or stipple shading, or just lines?

Is this a cover-up or adding to an existing tattoo? If so- please attach a photo of existing tattoo.

Also, attach any additional reference photos.