Consent to Piercing Procedure

I acknowledge by submitting this form it acts as an agreement that I have been given the full opportunity to ask any and all questions which I might have about the obtaining of a piercing and that all of my questions have been answered to my full satisfaction. I specifically acknowledge I have been advised of the facts and matters set forth below and I agree as follows:

  • I am not pregnant or breastfeeding / nursing. If I have any condition that might affect the healing of this piercing, I will inform my Piercer.
  • I do not suffer from medical or skin conditions such as, but not limited to keloid or hypertrophic scarring, psoriasis at the site of the piercing or any open wounds or lesions at the site of the piercing.
  • I have advised the Piercer of any allergies to metals, latex gloves, soaps and medications. I acknowledge it is not reasonably possible for the Piercer to determine whether I might have an allergic reaction to the piercing or processes involved in the piercing and further acknowledge that such a reaction is possible.
  • I am not under the influence of drugs or alcohol. To my knowledge, I do not have any physical, mental or medical impairment or disability which might affect my well-being as a direct or indirect result of my decision to have a piercing done at this time.
  • I acknowledge that obtaining this piercing is my choice alone and will result in a permanent change to my appearance, and that no representation has been made to me as to the ability to later restore the skin involved in this piercing to its pre-piercing condition.
  • I acknowledge infection is always possible as a result of obtaining a piercing. I have received aftercare instructions and I agree to follow all of them while my piercing is healing.
  • I understand I will be pierced using appropriate instruments and sterilization.
  • Therefore, I request the Piercer to do my piercing. I understand that piercings usually takes between 6 – 18 months or longer to heal.
  • I agree to release and forever discharge and hold harmless the Piercer and all employees from any and all claims, damages or legal actions arising from or connected in any way with my piercing, or the procedure and conduct used in my piercing.
  • I acknowledge I am over the age of sixteen and that I have truthfully represented to my piercer that the obtaining of a piercing is by my choice alone. I consent to the application of the piercing and to any actions or conduct of the representatives and employees of the tattoo and piercing shop reasonably necessary to perform the piercing procedure.
  • I understand that if I am under the age of 18, I require a parent to be present for this procedure and I am only able to obtain piercings in my ears or navel.
  • I fully understand THE PIERCING ARTIST DOES NOT ACT AS A MEDICAL PROFESSIONAL. Any suggestions made to me are NOT to be construed as or substituted for advice from a medical professional.
  • I accept the risk of COVID-19 and have been briefed upon entering the studio.
  • I do not present with signs of COVID-19, such as a high temperature, cough, or flu-like symptoms.
  • I give the representatives and employees of the tattoo shop permission to take photos / videos of the procedure and results of the piercing. I give full rights to use the images resulting from the photography/video filming, and any reproductions or adaptations of the images for fundraising, publicity or other purposes to help achieve the group’s aims. This might include (but is not limited to), the right to use them in their printed and online publicity, social media, press releases and funding applications.

Please complete the form below to show us you agree to the terms stated above & that we have your consent to perform this procedure.

Let us know if you have any questions !