Contact Information

First Name

Last Name

Phone *

Email *

Date of birth

Medical Information

Emergency Contact Phone Number

Emergency Contact Full Name

Do you have any of the following medical conditions? (Check all that apply)

Diabetes

Epilepsy

Heart Condition

Hemophilia (bleeding disorder)

Skin conditions (eczema, psoriasis, etc.)

Allergies (latex, ink, antiseptics)

Immunocompromised

Pregnant or nursing

Other

Are you currently taking any blood thinners or medications?

Yes

Do you have any allergies to tattoo products (inks, soaps, gloves, etc.)?

Yes

Tattoo Information

Is this your first Tattoo?

Yes

Tattoo Location

Full Sleeve

Full Leg

Full Back

Full Body

Arm

Back

Chest

Face

Foot

Hand

Head

Leg

Neck

Thigh

Have you been tattooed by us before?

Yes
No
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Which artist previously tattoed you?

Bryce Huffman

Warren Wase

Scottie James

Previous Tattoos

Please provide picture of any previous Tattoos completed by us

Tattoo Description

Preferred style (check all that apply):

Traditional

Realism

Black & Grey

Color

Linework

Fine Line

Other

Do you want the artist to freestyle/design something custom?

Yes

Maybe

Tattoo Examples

Please add any drawings, images or illistrations of the tattoo you would like to get

Which Artist Would You Like To Work With?

Bryce Huffman
Warren Wase
Scottie James
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Are you at least 18 years old and able to provide valid ID?