PIERCING WAIVER | Eterna Tattoo Studio

top of page

ETERNA TATTOO STUDIO

HOME
THE TEAM
GALLERIES
AFTERCARE
FORMS
CONTACT
FAQ
More

Use tab to navigate through the menu items.

Piercing Consent Form

Please fill out form in its entirety.

First Name

Last Name

Phone

Date of Birth

Emergency Contact Name

Emergency Contact Phone Number

Type of Piercing

Name of Piercing Artist

Please read and check each box when you are certain you understand the implications of signing this document.

All questions about the body piercing procedure have been answered to my satisfaction, and I have been given aftercare instructions for the body piercing I am about to receive.

I have been informed about what I can expect following the body piercing listed on the piercing consent form, including medical complications that may occur following this body piercing.

I understand that body piercing can result in nerve damage, bone and tooth loss, and that if I choose to remove my jewelry, permanent holes or scars may be left.

I am the person on the legal ID presented as proof that I am at least 18 years of age, or the body piercing will be performed in the presence of my parent or legal guardian.

I am not under the influence of alcohol or drugs and I am voluntarily submitting to body piercing without duress or coercion.

I understand there is a possibility of an allergic reaction to the jewelry inserted into the fresh body piercing.

I understand there is a possibility of getting an infection, and I have been advised of the signs and symptoms of infection that indicate a need to seek medical attention.

I agree to follow all instructions concerning the care of my body piercing.

I understand there is a chance I might feel light-headed or dizzy during or after being pierced.

I agree to immediately notify the body piercer in the event I feel light-headed, dizzy, and/or faint before, during, or after the procedure.

Please sign below.

I have been fully informed of the risks of body piercing, including but not limited to infection and other medical complications, allergic reactions to jewelry, nitrile gloves, and antibiotics (if required). Having been informed of the potential risks associated with receiving a body piercing, I wish to proceed with the procedure. I assume any and all risks that may arise from the body piercing.

Your Signature

Today's Date

ETERNA TATTOO STUDIO

eternatattoostudio@gmail.com

bottom of page