Tattoo Request Form

Name *

First Name

Last Name

Have you had symptoms or been in contact with anyone who has had symptoms of Covid-19 in the past two weeks? *

Yes

No

Tattoo Color *

Full Color

Black&Grey

Availability *

Open Availability

Limited Availability

Are you 18 years of age or older? *

Yes

No

Tattoo Artist *

Please select the artist of your preference

Ray Jerez

Any Available Artist