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Body Piercing

Let us do this part

Today's Date:

Wed Jan 28 2026 08:27

Please read and answer

Body Piercing Location*

Jewellery Type*

I confirm that I have discussed and agreed the above piercing location(s) with the Piercer prior to treatment.*

Please confirm your role in this consent*

Photo Identification*

I confirm that all consenting adults will provide valid government-issued photo identification.

I understand that body piercing will not be carried out unless valid photo identification is provided for the person giving consent.

Authority Verification*

Consent to Piercing Procedure*

I confirm that I consent to the body piercing procedure at the location(s) specified above.

Where the client is under 16 years of age, I confirm that I am a parent named on the birth certificate or the client’s legal guardian and that I give my consent for the piercing to be carried out.

Current Health Declaration*

In the past 14 days, have you experienced any of the following symptoms?

- Cold or flu-like symptoms
- Fever or high temperature
- Cough
- Sore throat
- Shortness of breath
- Loss or change in sense of smell or taste

I understand that if I answer Yes, my appointment may be postponed or cancelled in the interests of health and safety.
If Yes, please provide details:

Details:

Medical Conditions Declaration*

Do you currently have, or have you ever been diagnosed with, any of the following?

- Bleeding or blood-clotting disorders
- Regular use of blood-thinning medication
- Diabetes or blood sugar control conditions
- Epilepsy or seizure disorders
- History of fainting, blackouts, or vasovagal episodes
- Immune system conditions or reduced immunity
- Poor wound healing or keloid scarring
- Known metal allergies or sensitivities
- Pregnancy or possibility of being pregnant
- Currently breastfeeding or nursing

If Yes, please provide details:

Details:

Health Disclosure Confirmation*

I confirm that, to the best of my knowledge, I do not have any medical condition that may affect the safety, healing, or outcome of a piercing procedure, or that I have disclosed any such condition to the Piercer prior to treatment.

This includes conditions that may increase the risk of bleeding, fainting, infection, delayed healing, or adverse reactions.

I confirm that if I have received an organ or bone marrow transplant, or if I am taking immunosuppressive or preventative medication, I have disclosed this information.

I confirm that I am not currently pregnant or breastfeeding.

I confirm that all information provided is accurate and complete and understand that failure to disclose relevant information may increase the risk of complications.

Bloodborne Pathogens & Transmissible Conditions*

Do you have, or have you ever been diagnosed with, any bloodborne pathogens or transmissible conditions that may increase the risk of infection or transmission?

If Yes, please provide details:

Details:

Fitness & Capacity to Consent*

I confirm that I am not under the influence of alcohol, drugs, medication, or any substance that may impair my judgement or ability to give informed consent.

I confirm that I understand the nature, risks, and aftercare requirements of body piercing and that I have the mental capacity to make this decision.

I confirm that I am proceeding voluntarily and without pressure, duress, or coercion.

Jewellery Materials & Allergic Reaction Risk*

I understand that the studio uses implant-grade titanium or 14ct gold jewellery for fresh piercings.

I understand that although these materials are selected to reduce the risk of allergic reactions, adverse reactions may still occur in rare cases.

I confirm that I have informed the Piercer of any known or suspected metal allergies or sensitivities.

I confirm that I understand and wish to proceed.

Patch Testing & Sensitivity Awareness*

I understand that patch testing is not routinely required or standard practice for body piercing.

I understand that allergic or adverse reactions may still occur even where appropriate jewellery materials are used.

I confirm that I understand and accept the above.

Risks & Informed Consent*

I understand that body piercing carries inherent risks, which may include:

- Bleeding or bruising
- Swelling or prolonged redness
- Infection
- Pain or discomfort
- Allergic or adverse reactions
- Fainting or dizziness
- Migration or rejection
- Scarring or tissue changes

I acknowledge that healing times and outcomes vary depending on piercing location, anatomy, aftercare, and individual healing response.

I confirm that I understand the risks and consent to proceed.

Permanent Change to Appearance*

I understand that a body piercing may result in a permanent change to my appearance.

I understand that even if jewellery is removed, a piercing may leave a visible mark, scar, indentation, or change to the tissue, and that in some cases these changes may be permanent.

I understand that closure, scarring, or healing outcomes vary depending on the piercing location, anatomy, healing response, and aftercare.

Healing Time & Outcome Variability*

I understand that healing times and outcomes vary and that no specific result or timeframe can be guaranteed.

Aftercare & Healing Responsibilities*

I confirm that I have received, or been directed to, clear aftercare instructions and that I understand and agree to follow them.

I understand that complications may occur, particularly where aftercare instructions are not followed.

Jewellery Downsizing / Follow-Up Awareness*

I understand that piercings require jewellery downsizing or follow-up appointments as part of the healing process.

Right to Refuse or Stop Treatment

I understand that the Piercer may refuse or stop treatment at any time if there are concerns relating to health, capacity, anatomy, behaviour, or safety.

Acknowledgement & Limitation of Liability*

I acknowledge that body piercing carries inherent risks and that outcomes may vary.

Nothing in this agreement excludes or restricts any liability that cannot be excluded under Scots law. Subject to this, the Piercer and Studio are not responsible for complications arising from inherent risks or failure to follow aftercare instructions.

Photography & Media Consent (Optional) Photographs or video recordings may be taken for portfolio or promotional purposes.

Governing Law & Jurisdiction*

This agreement is governed by the law of Scotland.
The Scottish courts have exclusive jurisdiction.

Questions & Understanding*

I confirm that I have had sufficient time to read and understand this form and that my questions have been answered.

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.

Name:*

Address:*

Postcode:

Date of birth:*

If you are under 16 your parent/guardian will be required

Phone #:*

Email:*

Signature:*

Sign above or type signature:

Emergency Contact

If something happens, your emergency contact might need to explain your medical history, allergies, or medications.

Name:

Phone #:

Photo ID*

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