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Piercing Consent Form
Let us do this part
Today's Date:
Sat Oct 31 2026 10:40
Type of Piercing :*
Type of Piercing 2:
Type of Piercing 3:
Tooth Gem:
Jewellery Choice:*
Please read and answer
Y
N
Do you have any bloodbourne pathegens, transmittable disease or recent illnesses?
(Its okay if you do, we just need to know for our and other's safety)

Details: 
Y
N
Do you have diabetes or any long term illnesses or treatments?

Details: 
Y
N
Do you have any contact allergies, skin conditions or prone to keloiding?

Details: 
Y
N
Are you pregnant or currently breastfeeding?
Unfortunately we cannot pierce you if you are, for the safety of you and your baby!
Y
N
Are you due to going swimming (pool, hot tub or beach), visit a sunbed or be lucky enough to fly somewhere in the next 4 weeks?
Contact with non sterile water, heat, sand and air pressure severely increases your risk of infection and we advise to stay clear for at least 4 weeks while the internal wound is healing. If you go ahead, this is down to you!
Y
N
Are you on any hormone replacement treatment (excluding contraception but including HRT)?
This just might slow down the healing a bit!

Details: 
Y
N
Have you eaten before your appointment?
Make sure you eat at least 3 hours before your piercing to increase your sugar levels. Don't want you feeling wonky!
Y
N
Any wild parties last night?
We ask no drugs or alcohol 24 hours before your appointment please. It makes you bleed!
I UNDERSTAND A PIERCING IS A WOUND AND INFECTION CAN OCCUR DUE TO UNCLEAN ENVIRONMENTS OUTSIDE OF THE PIERCING ROOM.
I WILL FOLLOW ALL THE AFTERCARE ADVICE GIVEN AND CONTACT PRETTY PIERCED IMMEDIATELY WITH ANY QUESTIONS OR CONCERNS.
I understand Torz's aftercare services are free if I have done as I'm told but they can be chargeable if she has to fix anything due to my actions. I agree to attend follow up health checks while the piercing is healing and I understand that if the aftercare advice isn't followed then any aftercare service maybe chargeable.
I WAIVE LIABILITY ONCE I LEAVE THE STUDIO
I understand and accept that the piercing is being performed by a registered professional and under the recommended conditions; using equipment and techniques that comply with all the relevant statutory requirements and are certified by the local environmental health office and I have been given all the advice for safe healing.

I agree TO WAIVE AND RELEASE to the fullest extend permitted by law of the Artist and the 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, from the piercing, through fault or effect or otherwise.

I understand that the service I am signing for is carried out by a self-employed professional and I am paying for their time, supplies, regulation safety and years of experience and skill.
I agree to make payment for the service given and be respectful to the professional and her business.
Y
N
I am happy to have my photo taken and used for social media and marketing material. I shall let the artist know if I do not want my face/identity shown or if I'm happy being famous.
Help me help others and spread the word and let me know how you've found me at Pretty Pierced
- Google
- Instagram
- Facebook
- Social media advert or recommendation
- Recommended by friend
- The Black Arts
- Crows Nest
- Love & Ink
- Advert in town
- Other
 
Any questions or other information, please contact @prettypierced_byTorz via Facebook or Instagram or by email to torzcat@gmail.com

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:*
Chosen name:
Date of birth:*
 
If you are under 18 your parent/guardian will be required
Age: 
Phone #:*
Email:*
Social Handle:
If you don't mind us tagging you in photos online
Signature:*

Photo Identification *
Please take photo(s) of your government issued photo IDs and related paperwork
Please take a clear photo of your photographic ID if you're under 25!
This has to be in date and government issued eg a driving licence, passport or ID card showing your face, legal name and date of birth.
If the person getting pierced is under 18, then the parent or legal guardian must upload their photo ID plus your birth certificate showing them on it or the legal guardianship document with your ID