First name

Last name

Phone Number

Yes, allow communication from Em Nicole Tattoos. (This is required to communicate about booking!)

Pronouns (optional)

Medical Disclosure

Before moving forward, we need to ensure it is medically safe for you to be tattooed. Unfortunately, if any of the following apply, I will not be able to tattoo you at this time:

• Cancer, emphysema, HIV/AIDS, or any condition that weakens the immune system

• Use of blood thinners or antibiotics that suppress the immune system

• Pregnancy or breastfeeding

Please select one:

One or more of these apply to me

None of these apply to me

Age Requirement

Are you over the age of 18?

Yes

Group Tattoos

Are you getting tattooed with a friend? If yes, each person must submit their own inquiry form.

Yes

Tattoo Details

Tattoo Description: Please provide a detailed description of the tattoo you are looking to get. Be as specific as possible regarding subject matter, style, mood, symbolism, or inspiration. Incomplete or vague submissions may be declined.

Reference Images Upload: Reference images are very important. Please upload at least one image that helps communicate your visions.

Add up to 3 Files

Placement: Please describe where you would like the tattoo placed. If you are unsure, list your top two placement options. (Example: inner forearm, top of right thigh, center of spine)

Upload Placement Image: Please upload a photo of the body area where the tattoo will be placed.

Desired Tattoo Size: Please measure in inches and be as accurate as possible. (Example: 2 inches wide x 3.5 inches tall) If unsure, please use a measuring tape. Size is a major factor in pricing.

Tattoo Color: I currently only work in black and grey. If you are wanting color, please describe what color you'd want! (Optional)

Availability

Preferred Days and Times: Usual Hours of operation: Wednesday – Saturday, 10:30 AM–5:00 PM. Please list the days and times that work best for you within these hours. If those don’t work for you please list specific times and dates that do work for you!

Additional Information

Is there anything else you would like me to know? (Optional)

How did you hear about Em Nicole Tattoos?

Booking Form