I went to this shop a few years ago to have some work done. I custom-designed a wedding invitaiton for a friend and it involved having a die made.I brought in a mock up and a line drawing of the card and from those pieces, they were able to get it made.
I'm not sure if they did it on premises or if they outsource it, but they were still able to convey exactly what I wanted to the die maker.
The only thing, though, is that I wanted several blank cards but they came back all printed.
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