Piercing Troubleshooting
Peppermint Pediatrics
Name
First Name
Last Name
Caregiver name, if person experiencing issues is less than 18 years old:
First Name
Last Name
Date of birth
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Which piercing is giving you trouble?
One lobe
Both lobes
Ear cartilage
Nostril
Something else
Was the original piercing performed at Peppermint Pediatrics?
Yes
No
Date of the original piercing:
Studio or shop where the original piercing was performed, if it wasn't at Peppermint Pediatrics:
Please explain what's going on with the piercing:
Is there any drainage? Please describe if so.
Has there been any trauma to the piercing (such as: getting hit or bumped, snagged, etc)?
Does the piercing routinely get slept on?
What have you tried so far?
What kind of aftercare are you using and how often?
What kind of jewelry are you wearing in the piercing? (Regular earring, hoop, threadless jewelry, etc)
Where did you buy the jewelry?
Do you know what metal the jewelry is made of?
Do you know the gauge of the jewelry?
Do you know the brand of jewelry?
If you have a photo to share, upload it here:
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