Gallery 1 — Decorum

Name

First Name

Last Name

Pronouns

Phone

(###)

###

####

Preferred Contact Method

Scheduling request is for:

select all that apply

Myself (age 18+)

Myself (age 13-17)

Minor Child age 6-12yrs

Minor Child age 13-17yrs

Party of 2

Which piercing(s) would you like to consult on?

Notes or Special requests?

Ex preferred piercer or looking for a certain size/style of jewelry

What days/times work for you?

Ex: T, Th before 4pm, Sa after 12pm

Groups of 3 or larger please call to schedule