⇠
Stretching
Let us do this part
Today's Date:
Sat Mar 7 2026 03:46
Practitioner:*
Stretching Location:*
Jewelry Style:*
CLEAN. SAFE. PROFESSIONAL PIERCING
Photo Identification *
Please take photo(s) of your government issued photo IDs and related paperwork
Please read and answer
Y
N
Have you eaten in the past 4hrs? It's a good idea to before hand to increase your blood sugar levels.
Y
N
Do you have any bloodbourne pathogens, transmittable diseases or recent illnesses? (It' okay if you do, we just want to know for our and other's safety).
That I have been fully informed of the risks, associated with stretching 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 stretching a piercing, I still wish to proceed with the stretching and I freely accept all risks that may arise from stretching.
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.
I acknowledge that the stretching will result in a permanent change to my appearance and that my skin may not be restored to its pre-stretched condition even after its removal.
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.
If asked prior and given permission, 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. (If you do not tick this provision, please advise your piercer).
 
Thanks for choosing Diamond Eyez =^ _ ^=
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:*
Pronouns:
Chosen name:
Address:
Postcode:
Date of birth:*
 
If you are under 16 your parent/guardian will be required
Age: 
Phone #:
Email:*
Signature:*