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Body Piercing

Let us do this part
Today's Date:
Sun Jul 13 2025 04:32
Practitioner:*
Body Piercing location :*
Jewellery style, size and brand:*
notes:
Additional notes :
Aftercare purchased :*
Cycle number :*
Artist signature:*


Piercings by Rhian
Photo ID
Please take photo(s) of your government issued photo IDs and related paperwork.
Please upload valid photo ID. minors (under 16 years) need their own ID as well as parent/guardian.
Please read and answer
Y
N
HAVE YOU EATEN?*
Have you eaten in the past 2 hours? getting pierced is a trauma to the body and you'll need to have eaten for energy to sustain that trauma. You may also become unwell or faint, if you have not eaten then I cannot pierce you, please feel free to pop to the shop for a snack.
Y
N
BLOODBOURNE PATHOGENS*
Do you have any transmittable diseases or recent illnesses? (It' okay if you do, we just want to know for our and other's safety).
Y
N
POTENTIAL RISKS*
You fully understand any risks, known and unknown, that can lead to injury or trauma following a piercing, including but not limited to infection, scarring, keloiding, swelling, irritation 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.
Y
N
WAIVER*
I agree to WAIVE AND RELEASE to the fullest extent permitted by law each of the Artist, Piercer and Studio owners 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, Piercer or Studio owners or otherwise.
Y
N
QUESTIONS
Do you have any questions? The Piercer has given me the full opportunity to ask any and all questions about the piercing procedure and that they have been answered to my total satisfaction.
Y
N
AFTERCARE*
I affirm that I have and will be given verbal and written instructions on the care of my piercing while its 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. I understand that once I leave the piercing studio, I am solely responsible for the care of my piercing. I have been offered a recommended aftercare solution and that should I choose not to use it then I do so at my own risk. I understand that the use of any other cleaning or aftercare solution that has NOT been recommended or advised against by my piercer could result in the piercing becoming irritated, sore, rejected or infected. You agree that Should you have any issues or concerns with your piercing at any point during the healing process, then you will contact your piercer (Rhian) first for advice. You agree that should you choose not to seek my advice/help first and foremost (excludes professional medical help) and you choose to go to another piercer/studio for help/advice, resulting in you having to pay any additional fees to them for services, products or piercings, then you will not be reimbursed nor compensated in the form of any money, credit, gift vouchers, services, re-piercing or products by any member or owner at Mrs Ms Tattoos & piercings or piercings by Rhian
Y
N
DURESS*
I affirm that I am not under the influence of alcohol or drugs, and I am voluntarily getting a piercing without duress.
Y
N
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 do not have any conditions that may put my health at risk. I am not the recipient of an organ or bone marrow transplant or, if I am, I have taken the prescribed preventive regimen of anti-biotics that is required by my doctor in advance of any invasive procedure such as piercing. I am not pregnant or nursing.
Y
N
PERMANENT CHANGES*
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.
Y
N
DOCUMENTATION*
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.
Y
N
ATTORNEY FEES*
I agree to reimburse each of the Artists, Piercer and/or Studio owners for any attorneys fees and costs incurred in any legal action I bring against either the Artists, Piercer or Studio owners and in which either the Artists, Piercer and Studio owner is the prevailing party. I agree that The courts of Wales 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.
Y
N
PHOTOGRAPHY
I understand that Photographs will be taken of jewellery only including part or all of the ear. If it's a facial piercing then photos maybe taken of the whole face which can be blurred if necessary. 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. I have notified my artist/piercer if I wish not to be photographed.
Y
N
JEWELLERY REMOVAL/CHANGE *
I agree that should I have any concerns with my piercing during the healing period that I will contact my piercer as soon as possible. I will not remove or change the jewellery myself without consulting my piercer first. I will not use anything other than recommended jewellery and that if I do use anything else I do so at my own risk.
Y
N
CLASSIC & UPGRADED JEWELLERY*
I have been offered an upgrade on my piercing and understand that this costs extra. The piercer has ensured that my jewellery is on tight and secure, I understand that should I lose my jewellery once I leave the studio then I am liable to pay for a replacement. I understand that should my jewellery break once I've left the studio, its at the piercers discreasion to decide if they jewellery has broken due to a manufacturers default, if the piercer deems it as not a manufacturers default, I will have to pay to get it fixed or replaced.
Y
N
FILLERS, BOTOX AND OTHER ENHANCMENTS.*
I have not had any fillers, Botox or other enhancements in the area I am being pierced within the last 3 months. I understand that there may be complications resulting from being pierced where the area does have un-dissolved fillers, Botox or other such enhancements. These complications include but arent limited to disfigurement, leakage and wide spread or internal infection.
 
SOCIAL MEDIA
If you would like to be tagged in photos, please leave your social media name below.
 
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 16 your parent/guardian will be required
Phone #:
Email:*
Social Handle:
If you don't mind us tagging you in photos online
Signature:*


Emergency Contact
If something happens, your emergency contact might need to explain your medical history, allergies, or medications.
Name:
Phone #: