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BOOKING ENQUIRY FORM
name *
phone number *
email *
confirm you're over 18? *
will you be using a gift voucher with payment?
*
Yes
No
have you been tattooed by courtney before?
*
Yes
No
is the tattoo you'd like to book a continuation of courtney's previous work?
*
Yes
No
will this tattoo need to fit in a specfic gap, between other tattoos?:
*
Yes
No
if so, attach an image of the area
upload file
upload supported file (max 15mb)
would you like to book for multiple small tattoos at one session:
*
Yes
No
if you have a maximum budget please enter it here:
preferred days of the week for your appointment: (select all that apply)
*
Tuesday
Wednesday
Thursday
Friday
tattoo 1 - placement on body: *
tattoo 2 - placement on body:
tattoo 1 - size in cm *
tattoo 2 - size in cm
tattoo 3 - placement on body:
tattoo 3 - size in cm
brief description of tattoo idea(s): *
please attach up to 2 reference images
upload file
upload supported file (max 15mb)
upload file
upload supported file (max 15mb)
medical history (please select all that apply)
*
suffers from any heart conditions?
suffers from epilepsy?
suffers from haemorphilia / other clotting disorders?
suffers from any known blood borne virus? (eg. hep b / hep c / hep d / hiv)
suffers from diabetes or lupus?
suffers from any known allergic responses?
takes any prescribed medication regularly?
is the client pregnant and/or breastfeeding?
none of the above
medical history additional information?
i accept the terms & conditions *
view terms & Conditions
submit
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