Are You Older Than The Age of 18 *

• Yes
• No

Name *

First

Last

Email *

Phone *

Select An Artist *JacobThomasMarie

Have You Been Tattooed By Him Before? *

• Yes
• No

When Were You Last Tattooed By Jacob *

What Did He Tattoo On You *

New Tattoo Details

Is This A Touch-Up *SelectYesNo

Body LocationSelect Closest OptionInner BicepOuter BicepShoulderInner ForearmOuter ForearmChestCalfThighHipRibsFootShinAnkleStomachNeckFaceOther

Side of the bodyRightLeftCenterOther

Are You Looking For A Portrait (Specialty) *SelectYesNo

Are We Covering Scars/Tattoo? *SelectYesNo

Are you thinking of doing Black and Grey, Color, or a combination of the two? *SelectBlack and GreyColorCombination

Is This One Of His Flash Pieces? *YesNoOther

Tattoo Details *

Studio *SelectStudio, Address HereOther

Mark All That Apply To You/Your Tattoo

• Cover-Up
• Scars
• Black/Grey
• Color

Area Of The Body To Be Tattooed *

Side Of The Body

• Left
• Right

Picture of the area of the body being tattooed (not necessary for dermagraphics/repigmentation)

Click or drag a file to this area to upload.

Please upload up to 3 reference images *

Click or drag files to this area to upload. You can upload up to 3 files.

How Did You Find Us? *SelectGoogle SearchSocial MediaFriend/Family ReferralFlyerOther

Additional notes

Nobody under the age of 18 may be tattooed by me under any circumstances. Try again in a couple years.

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