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Tattoo Removal Questionnaire

Please remember to also schedule a phone consult or go back to the tattoo removal page after you submit this form. Fields marked with an * are required fields.

Tattoo Size

Please check the size of the tattoo:

Check all that apply:

Check all that apply:

Please indicate your skin type:

Please indicate your skin type:

Please check all colors that apply to your tattoo:

Please check all colors that apply to your tattoo:

Where is your tattoo located?

Where is your tattoo located?

Was your tattoo made by an amateur?

Was your tattoo made by an amateur?

Was your tattoo done by a professional?

Was your tattoo done by a professional?

Which best describes your tattoo?

Which best describes your tattoo?

Is your tattoo a cover up of an old one?

Is your tattoo a cover up of an old one?

Have you had any prior laser tattoo removal treatments?

Have you had any prior laser tattoo removal treatments?

Do you have any scars over the tattoo?

Do you have any scars over the tattoo?