Skip to main content
Hit enter to search or ESC to close
Close Search
facebook
instagram
messenger
email
search
Menu
Menu
search
Menu
HOME
ABOUT US
OUR ARTISTS
AFTERCARE
FAQS/INFORMATION
APPOINTMENTS
APPOINTMENTS
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
We need to collect a little information about you:
Layout
New or Returning Client?
*
New Client
Previous Client
Will you be using a gift certificate for this tattoo?
*
No
Yes
*Please note that if you answer no to this question and present a gift certificate at the time of your appointment, it will not be accepted as a form of payment. ALL certificates are valid for one year from the date they were purchased.
Name:
*
First
Last
Phone:
*
Social Media (Optional):
Age:
You must be at least 16 years old to be tattooed at Empire Ink and a parent or legal guardian must be present at all times. Proper documentation is also required.
Email:
*
Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Choose an artist that you'd like to work with:
Artist:
*
Scott Versago
Frank Miller
Alex Overbeck
Ron Newman
Ashley Denise
Mandy Papoon
Destinee Reed
Daryl Ratcliff
Gabby Piercy
Tiaaron Dejournett
No Artist Preference
Tell us about your Tattoo Concept:
Tattoo Information
Tattoo Placement
*
Arm - Entire Sleeve
Upper Arm - Outer Bicep
Upper Arm - Inside Bicep
Lower Arm - Inside Forearm
Lower Arm - Outside Forearm
Upper Leg - Upper Thigh
Upper Leg - Outside Thigh
Upper Leg - Inside Thigh
Lower Leg - Outside Calf
Lower Leg - Inside Calf
Lower Leg - Back Calf
Lower Leg - Shin
Foot
Neck - Throat
Neck - Side
Neck - Back
Back - Entire Back
Back - Upper
Back - Lower
Back - Center
Back - Shoulder Blade
Chest - Center
Chest - Pectoral
Chest - Under Boob
Torso - Ribs
Torso - Stomach
Hip
Hand
Head - Top
Head - Side
Head - Back
Head - Face
Color or Black & Grey
*
Black & Grey
Color
Is this a Cover-Up?
*
No
Yes
Description of your Tattoo Concept:
*
Reference Image Links:
Here, you can provide links to images that you'd like to send to your artist to help give them a better idea of what you envision for your tattoo. *Please keep each link separated per line.
Layout
How did you hear about us?
*
Facebook
Instagram
Search Engine
Skin & Ink Magazine
Referred by Friend or Family
Referred by Eric
Referred by Versago
Submit
Close Menu
HOME
ABOUT US
OUR ARTISTS
AFTERCARE
FAQS/INFORMATION
APPOINTMENTS