Body Piercing Consent Form

Collects informed consent and relevant health information from a client before performing a body piercing.

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In the Claude connectors directory

Please review the following before your appointment

Please acknowledge the following items:

I am at least 18 years old or have parental/guardian consent I understand the risks of infection and other complications associated with piercing I will follow the aftercare instructions provided I have disclosed all relevant medical conditions

Client Name

First Name

Last Name

Date of Birth

Phone Number

Please select the conditions you have:

Diabetes Bleeding Disorder/Hemophilia Allergies Skin Conditions Pregnancy None of the Above

Appointment

Date

Time

Signature

Sign here

Signed Date

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