Visuals by Mia Anika Custom Artwork Request Form
Welcome, new collector! It's a pleasure meeting you; I'm Mia Anika, visual artist and mental health advocate.
Thank you for your interest in my artwork; I look forward to working with you for your custom piece!

Please let me know what ideas you may have in mind for this work, such as subject/theme, size, colors, etc. by completing and sending in the form below.

Following your submission, I will send over a commission agreement which outlines terms, pricing, timeframe, etc. We can officially begin once these are in place.

Again, thank you for your selection; I appreciate your interest and look forward to speaking with you soon.

Warm Regards,

Mia Anika
Visual Artist| Mental Health Advocate| Speaker
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Order size: How many pieces total? *
For each piece requested, please answer the following questions.
Let's start with format: What type of work are you requesting? *
Do you have a particular medium in mind?
Theme or subject? What's the big idea? (Describe in your own words.)
Your answer
Color scheme?
How large would you like this piece to be? (inches) *
Captionless Image
Any other particular stipulations? Questions, comments, concerns?
Your answer
Thank you for completing this form! I will be in touch within 2-3 business days.
Once I have reviewed your responses, I will send you a commission agreement, including a quote and timeframe, for negotiation.
I will then compile your responses here to compose (3) initial sketches of your new piece (unless of course you have requested a print/reproduction). Work begins once initial payment has been received.
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