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Let us do this part
Today's Date:
Sun Nov 30 2025 02:17
Practitioner:
*
-- Select --
Jonny Z
Other
Please read and answer
Process
*
Permanent jewelry involves the custom fitting and welding of jewelry directly onto the body, creating a seamless clasp-free piece. The process is generally safe, but as with any procedure involving heat and metal, there are inherent risks.
Risk and Complications
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Possible risks include, but are not limited to:
* Minor burns or discomfort from the welding process
* Allergic reactions to metals
* Skin irritation or infection
* Jewelry snagging or breaking
* Need for professional removal in case of emergency or medical procedures
Aftercare
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Proper aftercare is essential to minimize risks. Instructions will be provided and must be followed to ensure jewelry longevity.
Medical Conditions
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The client affirmed that they do not have any medical conditions (such as allergies to metals, skin sensitivities, or other relevant health issues) that may interfere with the permanent jewelry process. If unsure, the client has consulted with a medical professional prior to the procedure.
Removal
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Permanent jewelry is designed to be long lasting, but can be removed by cutting the chain or jump rings. The studio is not responsible for any damage caused by self removal or removal by third parties.
Minors
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Clients who are under 18 years of age must have a parent or legal guardian present to provide consent.
Release of Liability
*
By signing this form, the client releases Tattoo Elemental, its owners, employees, independent contractors (including permanent jewelry artist, Jonny Z) and affiliates from any and all liability for injuries, damages, or complications that may arise from the permanent jewelry process.
Photography Rights
The client hereby consents to Tattoo Elemental and its associates to use photos of them and their jewelry as promotional images on website and social media advertising or other such uses. No compensation is given for such use.
Metal Allergies
Do you have a known allergy to metals?
Thank you for choosing Tattoo Elemental for your body art needs. We look forward to seeing you again.
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 or, if not, that my parent or legal guardian shall sign on my behalf, and that my parent or legal guardian is in complete understanding and concurrence with this agreement.
Legal Name:
*
Pronoun:
-select-
He/Him
She/Her
They/Them
He/Them
She/Them
He/She
He/She/They
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Date of birth:
*
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If you are under
18
your parent/guardian will be required
Phone #:
Email:
*
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Signature:
*
Sign above or type signature:
Parent/Legal Guardian
I, as custodial parent or legal guardian of the above minor under 18 years of age, hereby consent to the terms and conditions set forth in this release form and I attest that all documentation I have provided is true and accurate.
I understand that my child’s permanent jewelry will not stretch with their growth and I will need to return to have it removed. I may then purchase connectors or clasps from my artist which will lengthen the chain, making it once again usable for my child. I also understand that children are active, moving bodies which may cause excessive stress on their jewelry, causing it to break.
Guardian's Legal Name:
*
Relationship:
*
-select-
Natural guardian (birth parent)
Legal parent via marriage
Legal guardian via adoption
Other (provide proof)
Signature:
*
Photo ID
Please take photo(s) of your government issued photo IDs and related paperwork.
Remove Photo