Online Consultation Form

It is important that we know if you are a suitable candidate for cosmetic tattooing to ensure we get the best results.

Please fill out all information below, once I have reviewed your consultation form you will be given written approval via email to go ahead with scheduling your appointment online.

First Name

Last Name

Birthday

Phone

What area are you wanting treated?

Brows

Lips

Both

Have you had any previous tattooing in the requested area?

Yes

If yes, how long has it been since your last sessions and what was the name of the artist/salon?

Why would you like to have cosmetic tattooing?

How would you describe your skin type?

Oily

Dry

Combination

Normal

Please select your age bracket.

18-25

25-35

35-45

45-60

Are you currently using any skin medications or products that contain retinol, retin-A, glycolic or alpha hydroxil acids?

Yes

If yes, please specify what you are using/taking?

Are you currently breastfeeding or pregnant?

Yes

Are you currently using any blood thinning medications?

Yes

Do you have any health conditions?

Do you suffer from keloid scarring?

Yes

Do you suffer from coldsores? (Lip Clients)

Yes

Are you able to use topical anaesthetics? (lignocaine, tetracaine, prilocaine, epinephrine)

Yes

We will be in touch via email to confirm your acceptance as a new client.

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