Blackout Laser Tattoo Removal & Aesthetics goal is to make you feel comfortable. We understand the decision to remove a tattoo is personal and important. Your "Why" is part of your story and we want to hear it. We will work together to build your personalized removal plan and get you on the road to see the change you are after. This is your change, we are here to help! 

Please fill out ALL of the information requested on this form. If a question does NOT apply to you simply write "N/A" in the space (N/A means not applicable). The more information you apply on this client intake form will assist us in formulating a complete skin profile for you. This information is confidential!  you 

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