While anyone can design a tattoo, only a professional tattoo artist with the required state credentials should actually perform the act of applying the tattoo. Not all states require that a tattoo artist have certification; some only require certification for the tattoo establishment.
Many websites, such as TattooPlanner.com and TattooDesign.com, provide users with ways to create tattoos online. Tattoo artists accept sketches, printouts or verbal descriptions as starting places for custom tattoos. Customers can schedule appointments for planning, and it's up to the tattoo artist to make sure the tattoo is as close to the provided drawing or printout as possible.