Piercing Request Form
24 HOUR/SAME DAY BOOKINGS WILL BE TAKEN AS WALK INS DEPOSIT MAY OR MAY NOT BE COLLECT FOR THESE SAME DAY BOOKINGS
Name
First Name
Last Name
Date Of Birth
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Select Piercing
*
prev
next
( X )
Jewelry change, downsize or removal
$20.00
$
20.00
Quantity
1
2
3
4
5
6
7
8
9
10
Earlobes (Pair)
Please enter a short description.
$80.00
$
80.00
Quantity
0
1
2
3
4
5
Child’s Ear Lobes (3 months-5 years old)
$140.00
$
140.00
Single lobe
$60.00
$
60.00
Child’s Ear lobes (6-11yo)
$100.00
$
100.00
Quantity
1
2
3
4
5
6
7
8
9
10
Nostril *13 years and older*
$65.00
$
65.00
Quantity
0
1
2
Navel *13 years and older*
$65.00
$
65.00
Quantity
0
1
2
3
4
5
Helix *13 years and older*
$65.00
$
65.00
Double Helix
$120.00
$
120.00
Triple helix & triple forward helix
$160.00
$
160.00
Quantity
1
2
3
4
5
6
7
8
9
10
Lip (labret, vertical labret, medusa, Monroe) *14 years and older *
Price per 1
$70.00
$
70.00
Lip (2) (snakebites, spider bites, sharks bites)
$120.00
$
120.00
Ear cartilage (conch, daith, rook, snug, tragus)
$70.00
$
70.00
Eyebrow
$70.00
$
70.00
Bridge
$70.00
$
70.00
Industrial
$80.00
$
80.00
Dermal (1) *18 years and older*
$80.00
$
80.00
Septum
$70.00
$
70.00
Dermals (2)
$120.00
$
120.00
Surface bar/anti brow/anti tragus *18 years and older*
$80.00
$
80.00
Quantity
1
2
3
4
5
6
7
8
9
10
Tongue (vertical only, no horizontal or surface) *16 years and older*
$80.00
$
80.00
Male&Female nipples (pair) *18 years and older*
$120.00
$
120.00
Male&Female Genitals *18 years and older*
$140.00
$
140.00
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
24 HOUR/SAME DAY BOOKINGS WILL BE TAKEN AS WALK INS DEPOSIT MAY OR MAY NOT BE COLLECT FOR THESE SAME DAY BOOKINGS
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
Submit
Should be Empty: