Body Piercing Consent Form

I acknowledge by signing this agreement that I have been given the full opportunity to ask any and all questions which I might have about the obtaining of a body piercing and that all of my questions have been answered to my full satisfaction. I specifically acknowledge I have been advised of the facts and matters set forth below and I agree as follows:

• I am not pregnant or nursing or suffer from the following: epilepsy, hemophilia, diabetes, heart conditions or take any medication which thins the blood. If I have any condition that might affect the healing of the piercing, I will inform my piercer.
• If I suffer from hepatitis, or any other communicable disease, I have informed the piercer of this fact.
• I do not suffer from medical or skin conditions such as, but not limited to: keloid or hypertrophic scarring, psoriasis at the site of the of the piercing or any open wounds, infections, rashes, or lesions at the piercing site.
• I have advised the Piercer of any allergies to metal, latex gloves, soaps, and medications. I acknowledge it is not reasonable possible for the Piercer to determine whether I might have an allergic reaction to the piercing or processes involved in the piercing and further acknowledge that such a reaction is possible.
• I have trustfully represented to the piercer that I am over the age of eighteen (18) years. I am not under the influence of drugs or alcohol. To my knowledge, I do not have any physical, mental, or medical impairment or disability which might affect my well-being as a direct or indirect result of my decision to have a piercing done at this time.
• I acknowledge that obtaining this piercing is my choice alone and will result in a permanent change to my appearance, and that no representation has been made to me as to the ability to restore the skin involved in this piercing to its pre-piercing condition.
• I acknowledge infection and/or rejection is always possible as a result of obtaining a piercing. I have received aftercare instructions and agree to follow all of them while my piercing is healing.
• I understand I will be pierced using appropriate instruments and sterilization.
• I understand Shear Bliss Salon & Day Spa reserves all rights to use any photos of my piercing.

I hereby release and forever discharge and hold harmless my Piercer, Taylor Reimer, and all affiliates, owners, managers, and employees at Shear Bliss Salon & Day Spa from any and all claims, damages or legal actions arising from or connected in any way with my piercing, or the procedure and conduct used in my piercing, to the fullest extent allowed by the law.