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Ahimsa Piercing Studio

Let us do this part

Today's Date:

Fri Apr 26 2024 12:19

Practitioner:*

What are we piercing on you?:*

Appointment Date:*

Please read and answer

How did you hear about us?*

Eaten*

Have you had something to eat in the past 4hrs? It's a good idea to eat before hand to increase your blood sugar levels. Please let us know if you are prone to low blood sugar BEFORE your appointment.

Bloodbourne Pathogens*

Do you have any bloodbourne pathogens, transmittable diseases or recent illnesses? (It's okay if you do, we just want to know.)

Medical Conditions*

I affirm that I do not have diabetes, epilepsy, hemophilia, nor do I have a heart condition or take blood thinning medication. I do not have any other medical or skin condition that may interfere with the procedure or healing of the piercing. I am not the recipient of an organ or bone marrow transplant or, if I am, I have taken the prescribed preventive regimen of antibiotics that is required by my doctor in advance of any invasive procedure such as piercing. I am not pregnant or nursing.

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.

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.

Duress*

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

Questions*

That both the Piercing Practitioner and The Big Ocean Group, LLC dba as Ahimsa Piercing Studio, have given me the
full opportunity to ask any and all questions about the piercing procedure and the they have been answered to my total
satisfaction.

Aftercare*

All aftercare instructions are below, please read through them thoroughly.
YOUR AFTERCARE INSTRUCTIONS WILL ALSO BE GIVEN TO YOU DURING APPOINTMENT, VERBALLY AND WRITTEN.
I affirm that I have been given instructions on the care of my piercing while it's healing, and I understand and will follow them. I acknowledge that it is possible that the piercing can become infected, particularly if I do not follow the instructions.

Photography*

I release all rights to any photographs taken of me and the piercing and give consent in advance to their reproduction in print or electronic form. Please provide your Instagram handle so we can tag you.

Attorney Fees*

I agree to reimburse each of the Piercing Professionals and The Big Ocean Group, LLC dba Ahimsa Piercing Studio Fine Jewelry And Medical Aesthetics for any attorney's fees and costs incurred in any legal action I bring against either the Artist or the Piercing Studio and in which either the Artist or the Piercing Studio is the prevailing party. I agree that the courts of New York State shall have personal jurisdiction and venue over me and shall have exclusive jurisdiction for the purpose of litigating any dispute arising out of or related to this agreement.

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.

Release*

TO WAIVE AND RELEASE to the fullest extent permitted by law, each Piercing Professional and The Big Ocean Group, LLC dba Ahimsa Piercing Studio Fine Jewelry And Medical Aesthetics 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 Piercing Professional and The Big Ocean Group, LLC dba Ahimsa Piercing Studio Fine Jewelry And Medical Aesthetics, or otherwise.

Studio Restrictions*

I agree that I will come alone, or limit my group to just one person, at the time of my appointment. I understand that any additional guests will not be permitted, and will be asked to wait outside.

If you are under 18 years old, your parent or legal guardian who signs this form with you will count as your guest.

Thank you for choosing Ahimsa Piercing Studio & BVLA Fine Jewelry Boutique

The aftercare and maintenance of your piercing is essential not only for a happy and healthy, healed piercing but also to keep your immune system on the top of it's game. You’ve taken the time to choose the right piercer and jewelry for your body; don’t take the aftercare portion of the piercing lightly! With these easy to follow steps, you can help your piercing heal up quickly and with minimal discomfort. If at anytime, you are unsure about the process or if you have any questions, please contact us. We can easily be reached by text message or phone at (929)274-3371 and via email at ahimsapiercingstudio@gmail.com.

You will need:
*Sterile Saline Wound Wash (available at Ahimsa Piercing Studio or your local pharmacy)
*2x2 Individually packaged Sterile Gauze Pads
or
*Presoaked Sterile Saline Wipes (available at Ahimsa Piercing Studio or on Amazon).

To take care of your piercing, we suggest following these aftercare directions once daily for the first 8-10 weeks.
*Saturate the gauze with the Saline spray until it's completely soaked.
*Wrap the gauze around the piercing and apply light pressure. Enough pressure should be applied so the Saline drips over the jewelry. Do this for 2 minutes using one piece of gauze per piercing.
*The objective of the compress is to keep the piercing free of any hardened matter that may have accumulated throughout the day. Be sure the Saline is effectively rinsing your piercing each time.
*Before the end of each shower, allow warm water to run directly over the piercing for 10-20 seconds to clean any soaps and hardened matter off the jewelry.
*Take caution when combing/brushing your hair, dressing & undressing or any other simple routine that can hinder your healing.

DO NOT TOUCH your piercing unless your hands have been washed thoroughly. There is NO NEED to spin, rotate or move the jewelry. That's a myth and SUPER OLD SCHOOL!

We’d like to see you back in 10 weeks for a check and a possible downsize of the post, if needed.

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:

Chosen name:

Address:

Postcode:

Date of birth:*

If you are under 18 your parent/guardian will be required

Phone #:*

Email:*

Social Handle:

If you don't mind us tagging you in photos online

Signature:*

Sign above or type signature:

Photo ID*

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