Tattoo — Heartbreak Social Club

Please complete this form in full to request a tattoo appointment.

Please allow 48 hours for a reply and check junk and spam folders.

If you do not receive an email from us after 48 hours please email us to check.

For any general enquiries please contact us via email to welcome@heartbreaksocialclub.com

We also accept walk ins on a first come first served basis if we have space on the day.

Learn more

Name

First Name

Last Name

Phone

(###)

###

####

I confirm I am 18 years or older

Yes

Artist

*PLEASE READ BEFORE FILLING OUT A REQUEST FORM* If you cannot find an artist's name in the drop down menu then they are not currently taking bookings. We are strictly 18+ only for tattoos. If you are getting matching tattoos with one or more people you only need to send one request in and let us know how many people it's for.

Tattoo Design

A flash design is an original tattoo design by the artist that they have posted on their page as available to tattoo. A custom design is your own tattoo design/idea.

Flash Design

Custom Design

Tattoo Description

Colour or Black & Grey

Please ensure you select the correct option as not all artists do colour work.

Colour

Black & Grey

Tattoo Size

Please measure in inches or centimetres. It is very important this is accurate to be able to book you in.

Tattoo Placement

What part of the body and what side?

Preferred days or dates (If any)

Additional Comments:

Instagram Name

In case the artists needs to contact you.

Date Of Birth

Picture References - (6 max)

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