Apply to Path to Clarity | Free Laser Tattoo Removal Boston

Your Details

Full Name

First

Last

Date of Birth

Email

Phone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Eligibility Information

(Check all that apply to you)

Cancer survivor looking to remove radiation marker tattoos
Former gang member removing gang-related tattoos
Individual with hate/racist tattoos seeking removal
Formerly incarcerated individual reentering the workforce
Survivor of sex trafficking seeking tattoo removal
Other (Please explain below)

Single Line Text

Tattoo Details

Approximate Size of Tattoo(s):

Location of Tattoo(s):

Description of Tattoo(s):

Additional tattoo characteristics (choose all that apply)

Colored ink
Stick n’ Poke
Non-standard ink (ashes, pen ink, improvised pigments)
Traumatic (e.g., accident-related pigment, asphalt, gunpowder, etc.)
Cover-up tattoo (placed over another tattoo)
Previous tattoo removal attempts

Any additional details about the tattoo we should know about:

Consent (choose Photo

Personal Statement

(Please provide a brief statement on why you are seeking tattoo removal, how it impacts your daily life and how this will impact your future.)

Photo Submission

Optional: Upload a Photo of Your Tattoo (for faster, more accurate assessment). Photos are used only for assessment and are deleted after 90 days in accordance with our privacy policy

Drag & Drop Files, Choose Files to Upload You can upload up to 6 files.

Consent & Acknowledgment

Consent

I understand that submitting this application does not guarantee acceptance into the Path to Clarity program. If selected, I agree to follow the treatment plan and policies set by Clarity Tattoo Removal.

Name

Date

Goodbye to Regret. Hello to Clarity. 💙 Start Your Journey Today.