CONSENT FORM | Blacksails Piercing

Choose one of the following:

18+

Minor with consenting parent or guardian.

Were aftercare instructions gone over by the piercer to your satisfaction?

Yes

No

Was the healing process properly explained to you by the piercer?

Yes

No

Have you eaten in the past 4 hours?

Yes

No

Have you consumed alcohol in the past 8 hours?

Yes

No

Are you taking any medicaitons that could react with metal, cause excess bleeding or fainting?

Yes

No

Are you prone to fainting?

Yes

No

Do you have any fears around medical type procedures?

Yes

No

Have you provided your own jewelry today? (If yes, you take full responsibility for it.)

Yes

No

I understand that the piercer can not be held responsible for if/how my body reacts to the metal in the jewelry.

Yes

No

I understand that I am totally responsible for looking after my piercing.

Yes

No

I understand that sterilized jewelry and equipment and/or single use disposables will be used for my piercing.

Yes

No

I understand that Blacksails Piercing reserves the right to refuse service to anyone, for any reason.

Yes

No

This is an agreement between the piercer, the client and Blacksails Piercing indicating that full communication has taken place to ensure a legal, safe and successful body piercing.

Yes

No

Blacksails

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