Contact Information

    Name*

    Email*

    Phone*

    How would you like to be contacted?*
    EmailPhone

    About Your Tattoo

    What size is the tattoo (in inches)?

    Width*
    inches

    Height*
    inches

    Where is the tattoo located?*

    What is your skin type? How does your skin react in the sun?*

    How many years have you had the tattoo?*

    What color(s) of ink are the tattoo?*

    Has your tattoo been covered up?*
    YesNo

    Have you had any tattoo removal treatments before?*
    YesNo

    Is there anything else you think we should know?

    Please upload a photo of your tattoo. (2mb max size, PNG, JPG, JPEG, GIF)*