Custom Jewelry Design Order Form
Name (Last, First)
What kind of gemstone jewelry piece are you looking for?
Necklace and Earrings Set
Please tell me about your favorite gemstones
(Choose all that apply from the list below). I've listed only a few of my most commonly used stones, but please feel free to indicate any I missed under "other"
Is this item for a gift? If so, please tell me a little bit about the recipient.
What is your budget for this order?
This will help us determine what materials we should recommend for your piece.
When would you like to have the piece ready?
Would you like this order shipped or do you want to pick it up?
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