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Piercing Consent Agreement
Full Name:
Email:
Phone Number:
Date of Birth:
I am the person receiving the piercing and I am either at least 16 years old, or I have valid parental/legal guardian consent if under 16.
I confirm that for tongue, nipple, and certain facial piercings, I am at least 18 years old, or I have valid parental or legal guardian consent if I am under 18.
I confirm that I am not pregnant or nursing, and that I do not have any medical or skin condition that could affect healing, or I have disclosed such conditions to the piercer.
I do not have allergies to metals, latex, soaps, gloves, iodine, adhesives, or medications, or I have informed the piercer if I do.
I am not under the influence of drugs or alcohol today.
I understand that a piercing causes permanent changes to my body, and results may vary.
I accept the risks involved, including but not limited to: infection, nerve damage, allergic reaction, scarring, migration, rejection, and permanent holes.
I have read and received proper aftercare instructions and agree to follow them during the healing process.
I understand that I may feel lightheaded or dizzy and will notify the piercer if I do.
I acknowledge that all tools used are sterilized and disposable for hygiene and safety.
I understand that all jewelry sales are final due to health and safety regulations.
I understand that neither I nor anyone accompanying me may take photographs or record video in the piercing room.
I release the studio and staff from any liability regarding this procedure.
I have read, understood, and agree to all of the statements listed above, including the policy on photos and video in the piercing room and the liability release.
By checking this box, I confirm that I have read and understood all the above, and I voluntarily accept and agree to proceed with the piercing under these terms.
I hereby declare that I have read, understood, and agree to all the terms and conditions stated above.
I agree to the
Terms & Conditions
and
Privacy Policy
Initials (electronic acknowledgment):
Submit