Piercing Request Form
Name
First Name
Last Name
Date Of Birth
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Select Piercing
*
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Earlobe (Pair)
Please enter a short description.
$
80.00
Quantity
0
1
2
3
4
5
Nostril
$
60.00
Quantity
0
1
2
Helix
$
65.00
Lip (labret, vertical labret, medusa, Monroe)
Price per 1
$
70.00
Navel
$
65.00
Quantity
0
1
2
3
4
5
Ear cartilage (conch, daith, rook, snug, tragus)
$
65.00
Eyebrow
$
65.00
Septum
$
65.00
Triple helix & triple forward helix
$
160.00
Quantity
1
2
3
4
5
6
7
8
9
10
Industrial
$
80.00
Lip (2) (snakebites, spider bites, sharks bites)
$
100.00
Child’s Ears (11YO and younger)
$
100.00
Quantity
1
2
3
4
5
6
7
8
9
10
Single lobe
$
60.00
Dermal (1)
$
80.00
Dermals (2)
$
120.00
Surface bar/anti brow/anti tragus
$
80.00
Quantity
1
2
3
4
5
6
7
8
9
10
Male&Female Genitals
$
140.00
Male&Female nipples (pair)
$
100.00
Tongue (vertical only, no horizontal or surface)
$
80.00
Jewelry change, downsize or removal
$
15.00
Quantity
1
2
3
4
5
6
7
8
9
10
Double Helix
$
100.00
Appointment
*
Notes & questions you want to add
I agree with the following statements:
I will provide valid photo ID, if I am under the age of 18 I will bring my birth certificate, drivers license, drivers permit, school ID, or digital school ID & legal parent or guardian to sign paperwork for me
By booking this appointment a 30% despot WILL BE REQUIRED for my appointment to be accepted. Debit or credit card (in shop), Apple Pay or Venmo (digital) will be accepted. Red will reach out via text or email to see when you would like to put down your deposit over the phone or in person (deposit is required within 24 hours of your appointment slot or your appointment slot will be forfeited) Deposit will be applied to the total cost of your services , with full compliance with policy.
I understand failure to arrive on time, failure to bring a valid ID, failure to reschedule within 24 hours of my appointment time , or same day cancellations will result in forfeiture of deposit & entire appointment slot. (There will be an 8 minute wager if you are running late) Under these specific circumstances deposits are NOT REFUNDABLE
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