Piercing Consent Form

Thank you for choosing for your new piercing.

Your piercing will take around to heal.

We have outlined a few things that should help to heal your piercing:

• Aggravation (due to clothing on the area)
• Not using suggested aftercare products
• ANY contact with unwashed hands or bodily fluids

Hot Compress or Osmosis:

(Approx. 1/4 teaspoon of sea salt to 1/2 pint hot water) This method works best when used with hot but not boiling water.

Soak a cotton pad with the saline solution and place on the piercing for 5 minutes (until it starts to cool down). This helps to open the pores of the skin. Pour the remaining into a clean container that’s just big enough to cover the area (e.g. Navel/mug, Eyebrow/long contact lens case or an eggcup). Soak the piercing for 10 minutes, making sure water is warm at all times. This draws any of the impurities or trapped fluid out of the piercing.

Your antibacterial solution should then be used to clean the area. This can be Benzalkonium Chloride on a cotton bud or our antibacterial soap (Provon, Satin or Antibac) which should then be rinsed off thoroughly with CLEAN water.

This can be repeated a few times a week to heal a piercing, but when treating a problematic piercing twice a day is preferable.

Consent Form

I confirm that I am not taking any other medication or suffering from any other illness, condition or allergy which a reasonable person should be aware of that may react adversely to or be aggravated by piercing. I understand that a new piercing is susceptible to infection until healed and that proper aftercare of the piercing site once I leave the studio is my responsibility.

I confirm that I have been given the aftercare procedure in writing and that it has been explained to me and that I understand it. I also confirm that I will follow the aftercare procedure until the healing process is complete.

I understand that notwithstanding the hygienic conditions and sterile instruments, jewellery and techniques used by this piercing establishment, there are associated risks with piercing which include infection, scarring, allergic reactions, localised swelling, jewellery embedding and that the piercing may grow out.

In giving this consent I release this piercing establishment, and its employees from all liabilities, actions and demands which I may have now or in the future for any loss or damage suffered or howsoever caused as a result of my piercing (except as a result of a fraudulent mis-statement) or in respect of personal injury caused by ourselves, negligence and any failure on my part to follow the aftercare procedures.

Do you:

Heart conditions or seizures (e.g., epilepsy): Yes No

Haemophilia: Yes No

Haemorrhaging / bruise easily: Yes No

Immune compromising conditions: Yes No

High blood pressure: Yes No

Diabetes: Yes No

Allergic responses to adhesive plasters / creams / metals / latex / seafood / latex or wheatgerm: Yes No

Have you:

Taken blood thinning medication (e.g., aspirin in the last 24 hours): Yes No

Taken any recreational drugs / alcohol in the last 24 hours: Yes No

Eaten in the last 4 hours: Yes No

Slept well in the last 24 hours: Yes No

Are you:

Pregnant / a nursing mother: Yes No

Prone to fainting / dizziness: Yes No

Personal Information

Full Name:

Email:

Address:

Date of Birth:

Age:

Time:

I.D. Shown? Yes No

Parental Consent (if under 18)

Full Name:

Email:

Address:

Date of Birth:

Age:

Time:

I.D. Shown? Yes No

Signature

Please sign below:

Submit