tattoo appointment Request Form

Name *

First Name

Last Name

Phone *

(###)

###

####

Date of Birth *

MM

DD

YYYY

Is this tattoo a cover up? *

Yes

No

Color or Black and Gray? *

Color

B&G

NON-REFUNDABLE DEPOSIT *

A non refundable deposit may be required for your tattoo appointment. By checking this box you agree to these terms

Yes, I agree

Checkbo*Because you are using a third party request form, your email may send Billy's response to your spam folder. Make sure to check your junk mail if you don't receive a timely response! *

Yes, I understand