Body Piercing

Let us do this part

Today's Date:

Fri Jun 5 2026 04:14

Practitioner:*

Type of Piercing:*

SOLID GOLD TATTOO
253 MEACHAM AVE
ELMONT, NY 11003
516.673.4218
Solidgoldtattoo@gmail.com

Please read and answer

How did you hear about us?*

Risks*

That I have been fully informed of the risks, associated with getting a piercing. I understand that these risks, known and unknown, can lead to injury, including but not limited to infection, scarring and keloiding and allergic reactions. Having been informed of the potential risks associated with getting a piercing, I still wish to proceed with the piercing and I freely accept all risks that may arise from piercing.

Release*

TO WAIVE AND RELEASE to the fullest extent permitted by law each of the Artist and the Piercing Studio from all liability whatsoever, for any and all claims or causes of action that I, my estate, heirs, executors or assigns may have for personal injury or otherwise, including any direct and/or consequential damages, which result or arise, whether caused by the negligence or fault of either the Artist or the Piercing Studio, or otherwise.

Aftercare*

I affirm that I have given me instructions on the care of my piercing while it.s healing, and I understand them and will follow them. I acknowledge that it is possible that the piercing can become infected, particularly if I do not follow the instructions.

Duress*

I affirm that I am not under the influence of alcohol or drugs, and I am voluntarily getting a piercing without duress.

Medical Conditions*

Do you have diabetes, epilepsy, hemophilia, a heart condition?
Do you take blood thinning medication or any other medication that may interfere with the procedure or healing of the piercing?
Are you pregnant or nursing?

Details:

Permanent change*

I acknowledge that the piercing will result in a permanent change to my appearance and that my skin may not be restored to its pre-piercing condition even after its removal.

This Document*

I acknowledge that I have been given adequate opportunity to read and understand this document, that it was not presented to me at the last minute, and I understand that I am signing a legal contract.

Photography*

I release all rights to any photographs or videos taken of me and the piercing and give consent in advance to their reproduction in print or electronic form.

Payment*

We accept both cash and credit. A 4% service fee will be added to all credit card purchases.
WE DO NOT ACCEPT ANY TAP PAYMENTS IE APPLE PAY OR GOOGLE PAY

Latex*

Do you have an allergy to Latex.If yes, please also inform your Piercer.

PLEASE SHOW YOUR VALID PHYSICAL GOVERNMENT ID TO A SOLID GOLD STAFF MEMBER.

If any provision, section, subsection, clause or phrase of this release is found to be unenforceable or invalid, that portion shall be severed from this contract. The remainder of this contract will then be construed as though the unenforceable portion had never been contained in this document.

Client Information

I hereby declare that I am of legal age (with valid proof of age) and am competent to sign this Agreement.

Legal Name:*

Chosen name:

Address:*

Postcode:*

Date of birth:*

You must be 18 or older

Age:

Phone #:*

Email:*

Signature:*

Sign or type signature:

Photo Identification *

Please take photo(s) of your government issued photo IDs and related paperwork