Name
*
First Name
Last Name
Pronouns
*
Phone
(###)
###
####
Texting Preference
*
May we text you with questions and/or appointment updates, reminders, etc.?
Email
*
Returning Client?
*
Have I tattooed you before?
Tattoo Design
*
Please describe your tattoo request/idea. Make sure to include the images you wish to include/represent and, if possible, reference specific work (e.g., my prior tattoos, art work, botanical prints, names of flowers/birds/butterflies/moths, and/or concepts you wish to have represented ) that inform your idea for this project. You can see examples of my prior work on this website and on Instagram @renglasstatttoo. Please note, I prioritize projects that align with my artistic aesthetic whenever possible.
Tattoo Shading/Color Choice
*
Please select which format you would like for your tattoo.
Is this a Cover-up Tattoo?
*
Please indicate if this tattoo request includes a full or partial cover-up of an existing tattoo. Note my rate for coverups is higher and is outlined in my fee policy below.
Tattoo Size (in Inches)
*
Please write your desired tattoo size in inches. Note: Based on your design request, adjustments may need to be made to either the design or size. I will discuss this with you during email and/or in-studio consultations if necessary.
Weekday Availability
*
Are you able to schedule early-day appointments during the week? I do not have evening or weekend availability.
Cancellation List Preference
*
Please indicate if you have a flexible schedule and would like to sign up for the cancellation list. Signing up for the cancellation list increases your chance of getting an appointment if your submission is not initially selected for this round of booking. Also, if your submission is selected this round, agreeing to be on the list may result in a sooner appointment time.
Client Travel
*
Please Indicate if you are local to NYC? (i.e., in driving or easy commuting distance or if you will be making arrangements to travel a long distance for your appointment). If you are planning to travel to Brooklyn, please let us know. We recommend travel insurance in case of sickness, weather etc.
Fee Policy Acknowledgement
*
My rate is $300/hour for the total appointment time. Full-day sessions will be scheduled for up to 5 hours at a flat day rate of $1500. Coverups are $350/hr with a $1750 day rate. If your full-day session exceeds 5 hours you will be charged the hourly rate for all additional time. Smaller tattoos are a flat rate based on size, placement, color and detail. A deposit is required for all appointments. My full fee policy can be found on my website. If you have budgetary restrictions, let me know in the next section.
Budgetary Restrictions (Optional)
Pleases share any budgetary restrictions or considerations (if applicable). If not, please skip this section.
Medication
*
Are you currently on any medications (like blood thinners or Accutane/acne medication) that may impact your ability to get tattooed? If you answered "yes" to this question, please share further information in the "other" section at the end of the submission form and make sure to consult your doctor prior to getting tattooed.
Dermatology/Skin
*
Are you in treatment for any health issues that may make getting a tattoo unsafe for you? Have you ever been diagnosed with a melanoma or other skin conditions that would need a dermatologist's approval prior to getting a tattoo? If you answered "yes" to this question, please share further information in the "other" section at the end of the submission form and make sure to consult your doctor prior to getting tattooed.
Client Medical Responsibility
*
If you are taking any medication, have existing medical conditions, are receiving treatment, etc. it is your responsibility to contact your medical provider(s) prior to getting tattooed, healing post-tattoo, etc. to discuss any potential concerns, questions, or other considerations.
Studio Accessibility
*
My studio is on the 3rd floor. If you are not able to walk up 2 flights of stairs, please let me know so we can arrange the use of our freight elevator.
Additional Acknowledgements
*
Please read and agree to the following statements:
1. I understand that I must wait 10-14 days after getting tattooed before swimming and using sunscreen.
2. I acknowledge that sunburnt skin cannot be tattooed.
3. I understand that I must eat before my appointment on the day of my appointment.
4. I acknowledge that I will not use numbing cream on my skin prior to my tattoo appointment and if I wish to use it, I will discuss this with Ren prior to my appointment.
Other Information
Please share anything else you want to let me know?
