Thanks so much for your interest in being tattooed at Loose Screw Tattoo! Submit your idea with us and we will connect you with one of our amazing artists! If you are trying to submit a tattoo design for Jesse Smith, please make your submission HERE.

    Your Name (Required):

    Birthdate: (Required; must be +18 years old to get tattooed.)

    Phone Number:

    Location: (City,State,Country):

    Email Address:

    Confirm Email Address:

    Preferred Contact Method:

    May we send you email updates?

    How did you hear about us?

    If you selected "Other", please specify:

    Color or Black/Grey?:

    Tattoo Placement: (Arm, Leg, Neck, Face, etc.)

    How big do you want your tattoo to be? (Either in inches or standard tattoo sizes: Sleeve, Half Sleeve, 3/4 Sleeve, etc):

    Are you willing to get tattooed monthly until this project is complete? (Depending on the size and complexity of the tattoo, multiple sessions may be necessary.)

    What is your budget for the entire project?

    Brief Description: (We will request reference photos after receiving this form.)

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