First Name *

Last Name *

Email *

Phone Number *

Other :

You must be over 18 to receive a tattoo, permission from a parent does not change this. *
Yes , i am above 18

General availability for appointment *

Is this tattoo a scar cover up or tattoo cover up ? *
--Select Please--Yes, scar cover upYes, tattoo cover upNo

Where do you want your tattoo on your body? Please give approximate size in cm *

Any reference pictures for the style or subject that they want tattooed

Other:

Please describe your tattoo idea *

Other :

Are you vaccinated against COVID 19? *
--Please Select--YesNot intending to be vaccinatedPartially vaccinated or booked in

Do you have any special needs? *(Wheelchair access, sensory needs, support worker etc.) please provide details