Surname, First Name*
    Birth Date *
    Street, No *
    Zip Code, City *
    Mobile number
    How old is the tattoo? *
    Where is the tattoo *
    How big is the tattoo *
    What color? *

    Ever got a cover-up? *
    If yes, when?

    Did you have problems after tattooing? *
    If yes, which?

    Is a cover-up planned? *
    What is her natural hair color like? *

    How does your skin react to the first sunbathing? *

    Have you been exposed to strong sunlight or in a solarium in the last 4 weeks? *
    Are you particularly sensitive to light or do you have a so-called sun allergy (photosensitivity)? *

    Do you have skin changes in the areas to be treated? *
    If yes, which?

    Are you prone to excessive scarring (keloid)? *
    Are you pregnant or breastfeeding? (Pregnant women are generally not lasered)
    Do you smoke? (In smokers, the pigments are broken down much more slowly) *
    Do you suffer from varicose veins, thrombosis or swelling of your feet? *
    Is there an increased tendency to bleed (hemophilia, blood thinning) or do bruises appear easily? *

    Do you have the following diseases?
    Are there other current or previous illnesses that were not covered by the previous questions?
    Do you suffer from allergies to creams, medicines or other things? *

    Are you currently using cream, medication or homeopathic remedies? *
    If yes, which?
    Other medications?
    Signature (please sign with your finger or mouse) *

    Are you interested in a treatment?

    Then make an appointment for tattoo removal in Berlin now!