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Check up (all)

Let us do this part
Today's Date:
Sun Jul 13 2025 03:46
Practitioner:*
Cycle number:*
Notes:*
Check up on existing piercings either preformed by Rhian or by another piercer at another shop.
Please read and answer
Y
N
Irritated piercing*
I agree that Rhian has throughly checked my piercing and there are some issues with the piercing and further steps need to be taken to help aid healing
Details:
 
Y
N
Check up*
I agree that Rhian has throughly checked my piercing, that it is healing well and I'm satisfied with my check up and the advice I've been given.
Y
N
Downsize*
I have received a downsize at this appointment and am happy with the outcome.
Details:
 
Y
N
Removal*
My piercer has removed my piercing as they feel it is not healing well. I've understood further aftercare advice and we've discussed and agreed the next steps.
Details:
 
Y
N
Jewellery change *
I have received a jewellery change to either a ring or another stud and front and have been advised that I may experience soreness, irritation or swelling in the first few weeks and that I will contact my piercer if I have any concerns and will not remove my jewellery until I have seen my piercer.
Details:
 
Y
N
Problematic piercing*
I have been pierced by another piercer at another studio and have come to Rhian for help. I am happy to take on board any advice that Rhain has offered.
Details:
 
By filling out and signing this disclaimer you agree that you are happy with the piercers advice and notes and that if You do not follow them then you do so at my own risk.
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:*
Signature:*