Appointment Request Form

Name

First Name

Last Name

Pronouns

he/him, she/her, they/them, etc.

Phone Number

(###)

###

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Traveling?

Let me know if you’re traveling into Charlotte for your appointment, or if you’re local.

Description of Tattoo

Please include as much detail as possible, including subject matter and any important inclusions.

Location on Body

such as left inner forearm, full chest, back of calf, etc.

Sizing Desired

Good examples include 4in x 4in, hand-sized, quarter/half/full sleeve, etc.

Notes

Anything else you’d like to include? Drop it here!