Tattoo Consultation Form

Client Details

Full Name: *

Date of Birth: *

Contact Number: *

Email: *

Please upload a clear image of proof-of-age documentation *

Are you currently taking any medications? *

Please list: *

Do you have any allergies? *

Please list: *

Have you recently been unwell? *

Which of the following were you unwell with? *

Please provide more detail: *

Emergency Contact Details

Emergency Contact Name: *

Emergency Contact Phone: *

Emergency Contact Relationship: *

Tattoo Information

Please select the appropriate option: *

I just have some general questions and don’t have a specific design in mind yet I want to discuss a particular tattoo that I would like drawn/designed I just have simple changes to an existing design

Please give a brief description of the tattoo: *

Please upload any reference images:

We would like to see any images that have inspired this tattoo or can help convey what you want to get. We aren’t necessarily asking you to send an image of exactly what you want, we just need some examples that you feel convey any part of this tattoo so we can prepare for your appointment

Please upload any reference images:

We would like to see any images that have inspired this tattoo or can help convey what you want to get. We aren’t necessarily asking you to send an image of exactly what you want, we just need some examples that you feel convey any part of this tattoo so we can prepare for your appointment

Please upload any reference images:

We would like to see any images that have inspired this tattoo or can help convey what you want to get. We aren’t necessarily asking you to send an image of exactly what you want, we just need some examples that you feel convey any part of this tattoo so we can prepare for your appointment

Color choices: *

Please specify:

If you have a preferred artist please specify:

Any additional comments/notes:

Client Signature: *

Tap or click on the signature above to sign