RELEASE & CONSENT FORM

Please read carefully, and fill out this form. When you are done, have your piercer sign it along with your own signature.

Choose one of the following:
Were aftercare instructions gone over by the piercer to your satisfaction?
Was the healing process properly explained to you by the piercer?
Have you eaten in the past 4 hours?
Have you consumed alcohol in the past 8 hours?
Are you taking any medicaitons that could react with metal, cause excess bleeding or fainting?
Are you prone to fainting?
Do you have any fears around medical type procedures?
Have you provided your own jewelry today? (If yes, you take full responsibility for it.)
Services Requested
I understand that the piercer can not be held responsible for if/how my body reacts to the metal in the jewelry.
I understand that I am totally responsible for looking after my piercing.
I understand that sterilized jewelry and equipment and/or single use disposables will be used for my piercing.
I understand that Blacksails Piercing reserves the right to refuse service to anyone, for any reason.
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.
Do any of the followig apply to you?
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