top of page

Exclusive Tattoo Request Form

One design. One story.


Choose an exclusive JINDHAMMA design, share how you’d like to wear it, and select your preferred date and time. Exclusive designs are available to be claimed once only. Your appointment is confirmed only after review and written confirmation.


View Service Details

1. Contact Information

2. Your Tattoo

Enter the design name or number.

Upload an image or screenshot of the JINDHAMMA exclusive design you’d like to claim.

How would you like to wear this design?
One person — complete design
Two people — one element each
Other / Not sure

Some exclusive designs may be created as a single piece, while others may be suitable as a pair or multi-piece composition.

Enter your preferred size in inches. If the design includes more than one element, please include the preferred size for each. If you’re unsure, enter “Not sure.”


Exclusive designs are offered as shown. Size may be adjusted to suit placement, readability, and body flow. Minor placement-related adjustments may be made where necessary. Requests for significant changes to the artwork may require a Custom Tattoo Request instead.

Where would you like the tattoo placed? If the design includes multiple elements, specify the placement for each.

Upload a clear photo of each area you’d like tattooed. This helps me evaluate placement, size, and body flow.

Requested Exclusive Service

Final size and total pricing are confirmed after review. Pricing may vary if a larger size or different placement requires additional tattooing time.

3. Appointment Availability

Please select your preferred available date and start time.
Sep - Oct 2026
SunMonTueWedThuFriSat
Week starting Sunday, September 27
Time zone: Coordinated Universal Time (UTC)Business location
Saturday, Oct 3
10:00 AM - 11:00 AM
11:00 AM - 12:00 PM
12:00 PM - 1:00 PM
1:00 PM - 2:00 PM

Please note: Session length varies by design, size, placement, and number of tattoos and may be shorter or longer than the time shown. I’ll confirm your start time and estimated duration after reviewing your request.

Share any dates or times that work best for you. Subject to availability.

4. Health & Safety

Is there anything about your health, skin, medications, allergies, or healing history that could affect tattooing or aftercare?*
No
Yes
I’m not sure

Examples include conditions or medications affecting bleeding, immunity, or healing; current illness or infection; skin irritation at the placement area; allergies or sensitivities; or a history of raised scars or keloids.

Are you currently pregnant or breastfeeding?
No
Yes

Tattoo services are not provided during pregnancy or breastfeeding.

5. Additional Information

Share any accessibility needs, previous tattoo experiences, placement questions, or anything that may help me provide a safe and comfortable experience.

6. Confirmation

By submitting this form, I acknowledge that I have had access to the Privacy Policy and Consumer Health Data Privacy Policy.

bottom of page