Tattoo Request Form

Legal Name

The name on your legal documents.

First Name

Last Name

Preferred Name and Pronouns

Phone

(###)

###

####

Instagram

Are you a returning client?

Is this your first tattoo?

Please describe the tattoo you're looking to receive.

Add as much detail as possible, and any remarks about the references you provided. If you chose Flash, please specify which piece you're interested in.

Please paste any reference image links here:

I suggest making a google document or pdf with an inspiration/mood board if you have more than 3 references and then uploading a link to that (this allows you to write notes near the images.)

http://

Black & Grey or Color?

Tattoo Placement

Inner/Outer/Upper/Lower: Arm/Leg/Back, etc.

Tattoo Size Range

Tattoo Budget

You can click one or more, but you must ALWAYS click a number value when you click "Sliding Scale", because I need this context. The Minimum is always $200.

$200-$300

$350-$450

$500-$600

$650-$750

$800-$900

$950-$1000

$1000+

Sliding Scale

Preferred Date

My days of operation are Wednesday - Saturday.

YYYY

Preferred Time

My hours of operation are: Wed-Fri: 3pm-9pm. Sat: 12pm-6pm

Hour

Minute

Second

2nd Preferred Date

My days of operation are Wednesday - Saturday.

YYYY

2nd Preferred Time

My hours of operation are: Wed-Fri: 3pm-9pm. Sat: 12pm-6pm

Hour

Minute

Second

3rd Preferred Date

My days of operation are Wednesday - Saturday.

YYYY

3rd Preferred Time

My hours of operation are: Wed-Fri: 3pm-9pm. Sat: 12pm-6pm

Hour

Minute

Second

Service Agreement

I have read and agree to all the terms and conditions presented in Ilia's Service Agreement.