Purpose and Risks:
Permanent Jewelry is a process that involves the use of welding the jewelry together while on your body. The procedure is painless and is performed with your safety in mind. This consent form is intended to inform you of the procedure and to obtain your informed consent for the procedure.
Consent and Care:
I understand that although rare, an allergic reaction to the jewelry can occur.
I understand that the welding procedure does have some risks.
I agree to not look directly at the spark from the welder without proper eye protection.
I agree to the jewelry care instructions recommended by the technician.
I understand that although this jewelry is intended to be permanent, durable and long lasting, the length of wear can vary depending on my physical activity, sports, lifestyle, body ph levels and other factors.
I understand that metal tarnishing and skin discoloration are rare but can occur due to environmental pollutants that may result in high ph levels and/or chemical exposure.
I understand that all sales are final. Citrus Blossom Creations is not liable for broken, damaged or lost items.
I understand the free re-weld warranty covers broken chains only and not lost chains.
I understand that there may be some instances where I will be required to remove my jewelry, including but not limited to medical procedures like MRI and surgery. I understand that the jewelry can easily be removed with nail clippers and re-attached by the jeweler for free at a later date.
Consent and Release:
I voluntarily and willingly consent to the permanent jewelry procedure and assume any risks associated with it. I release Citrus Blossom Creations, its practitioners, employees, and affiliates from any liability for complications, injuries, or damages resulting from the procedure. This agreement remains in effect for this procedure and any follow-up appointments.
Age Verification:
I confirm that I am at least 18 years of age, or if I am a minor, I have obtained the consent of my parent or legal guardian for this procedure.
I confirm that the person wearing the jewelry is at least 13 years old.
Photo Release:
I give permission for photographs or videos of the procedure and the jewelry placement to be taken for marketing and promotional purposes.
Signature:
I have read and understood this Permanent Jewelry Consent Form, and I sign it of my own free will.