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♡Moth Teeth Booking Request♡

In order to help me streamline the booking process, please fill out any relevant information I may need for your appointment below. If there is a question you do not understand or are not sure how to answer, give a best guess and let me know at the end how I can help!

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Before We Begin

Please read all relevant policy information below!

Thank you so much for taking the time!

Deposit Policy:

All Projects require a non-refundable deposit prior to booking -$100 deposit for half days or less -$200 deposit for full days Deposits are nonrefundable but do apply to your overall cost of project. Multiple sessions do not require a new deposit each time however the deposit is applied to the final session. ♡48 hour notice is required for rescheduling sessions or major design changes. Failure to do so may result in loss of deposit. ♡ -one reschedule allodet before impacting deposit - no call no shows will result in forfeited deposit As deposits apply to your appointment, forfeited deposits must be replaced before reschedule is possible.

Design Policy:

I only take on projects that I feel suit me as an artist and allow for artistic freedom. I am open to many styles however I will always prioritize projects with creative freedom, especially art from my available flash, portraits, black and grey (realism), or American traditional projects. I choose not to tattoo: -clients uner the age of 18 -political/hate symbols - inner lip tattoos -couple names

Let's get started!

Tell me about you

♡Pronouns

♡Phone number

♡Email (this is how I will be contacting you)

♡Instagram

What is the most reliable way to reach you?

What is the most reliable way to reach you?

1. Describe your tattoo idea here!

Tattoo Placement

♡Tattoo size

♡Tattoo location/size reference if comfortable you can insert a photo of the area we will be working on

Is this a coverup of any kind: full or partial?

Is this a coverup of any kind: full or partial?
A
B
C
D
If there is a cover-up involved, please take a well-lit photo of the tattoo or scar that you would like covered as well as some area around it. Also, please note the age of the existing tattoo/scar in the description box.

What styles are you comfortable with/prefer for this tattoo?

What styles are you comfortable with/prefer for this tattoo?
A
B
C
D
E
F
G

Color or B/G

Here is a place to insert any references you like for your tattoo

Upload references for subject and style. These are for inspiration and I prefer to custom draw every piece unless otherwise directed. If you have references for me, please include all of them here so I have everything here in one concise place.

Preferred days of availability

Preferred days of availability

Preferred Time of Day to Start

This is not set in stone until we confirm our session, just a helpful guideline for us!
Preferred Time of Day to Start

Are you located in Tempe or will you be traveling to your appointment?

Are you located in Tempe or will you be traveling to your appointment?
A
B

It may be necessary to schedule an in person consultation prior to your appointment depending on your tattoo requirements,. If this is not possible, you may specify or we can discuss if we need more information!

It may be necessary to schedule an in person consultation prior to your appointment depending on your tattoo requirements,. If this is not possible, you may specify or we can discuss if we need more information!
A
B

Anything else i should know about your availability?

What is your budget for this tattoo (if any)?

I give price/time estimate prior to booking. If your budget is out of line with my work, we can always discuss options to make sure we can meet your needs or I may recommend another artist.

Medically Relevant Info:

Medical conditions that may require guidance and/or special care (you do not have to share this information, this is to inform me if desired so we can best prepare for your session)
Medically Relevant Info:

By checking this box you confirm that you are not pregnant or breastfeeding.

By checking this box you confirm that you are not pregnant or breastfeeding.

Inquiries & Additional Comments

By checking this box you confirm that you read and understood my Deposit Policy and all other information provided

By checking this box you confirm that you read and understood my Deposit Policy and all other information provided

♡ Thank you so much for your interest in my work! Please note that at this time bookings are limited in order to allow our shop to operate as safely as possible so please allow some time for your artist to reach out to you! ♡

Please verify that you are human (Robots don't get tattoos!)