Piercing Request for MINOR

Piercing Request Under 16yrs

Miss Eliesha at "In Katharsis"
Welcome, and thank you for choosing me for your child’s piercing.

This is a request only (not a confirmed booking).

This form must be completed by a parent/legal guardian, with the child involved where appropriate.
After you submit, I’ll review your request and email you with available appointment times and deposit details (please check your junk/spam folder). If you’d like to follow up on your request, you’re welcome to email misselieshatattoo@gmail.com

Once an appointment time is confirmed, a deposit is required within 24 hours to secure the booking. If payment isn’t received within that timeframe, the appointment may be released. You’ll receive a confirmation email once the deposit has been paid.

All information (and any images provided) are kept strictly confidential.

Professional Standards & Safety
I take a safety-first approach to every piercing. All piercings are performed using sterile, single-use needles (no piercing guns). Jewellery is implant-grade titanium only, using internally threaded or threadless designs to support comfort, reduce irritation, and promote a smoother healing process. I follow strict infection control and sterilisation standards and work in line with industry best practice, including guidance and education supported by the Association of Professional Piercers (APP).

Parent/guardian reminder
A parent/legal guardian must be present for the entire appointment. On the day, you’ll be required to provide the relevant documentation for consent, including parent/guardian photo ID, Medicare card, and the child’s birth certificate (as requested in the consent form). Your child can pause or stop at any time, and there is never pressure to proceed.

Important: Before continuing, please read the Booking Information. This includes ID and age requirements, studio expectations, rescheduling/cancellation terms, and important safety information.

Comfort, Consent & What to Expect

If you or your child would feel more comfortable meeting first, I’m happy to offer a brief complimentary consultation before booking. In some cases, I may also recommend this so your child can get a feel for the space, ask questions, and make sure the experience feels right.

There is absolutely no pressure to go ahead. If your child changes their mind at any point, that is completely okay. If they are booked for both lobes but only feel comfortable doing one on the day, we can simply stop at one.

My priority is a safe, respectful, and positive experience, and I will never pressure a child to proceed with anything they don’t feel ready for.

During the appointment, I’ll speak directly to your child so they feel informed, comfortable, and in control throughout the process. If you’re happy to allow them the space to answer and ask questions themselves (with you there supporting), and only step in if needed, it’s greatly appreciated.

Acknowledgement: I understand my child can pause or stop at any time, there is no pressure to proceed, and Eliesha will speak directly with my child to support comfort and informed consent.

Click Next to continue.

Parent/ Legal Guardian Information
Parent/Legal Guardian Name*

First NameLast Name
Relationship to child?*
Mobile Number*
Email*
I will contact you at this email about your enquiry and booking so please check it is correct, and check your junk folder for a response in case it gets directed there.
Minor Information
Minor Name*

First NameLast Name
How old is the Minor?*
I do not to pierce children under the age of 6. This decision is based on ensuring the safety and comfort of young children during the procedure.
Is this the MINORS first time being pierced?*
Since everyone's anatomy is unique, the piercing you want may not always be possible. Please upload a photo of where they would like the piercing, so I can check if it's suitable or if we need to discuss other options.

If you're not comfortable uploading a photo, an in person consultation is recommended before booking. All images you provide are kept confidential.
Cancelof
For this booking, which piercings are you interested in getting? Price includes piercing service & jewellery. 1 piercing per booking, except for both lobes.*

CONSULTATION ONLYLOBE - $80BOTH LOBES - $150HELIX - $110CONCH - $110DAITH - $130 (for potential migraine relief)NOSTRIL - $100NAVEL - $130JEWELLERY CHANGE - $30 FEE
Are you happy to go with plain titanium jewellery for the initial piercing, or would you prefer a gem piece?*
A gem piece will incur an additional $10ea and may require downsizing once healed, but is yours to keep.
Please provide the days and times you're available, and I'll do my best to schedule accordingly.*
Does the Minor have any allergies?*
If yes, please explain.
Is the Minor taking any medication that may affect the procedure or healing process?*
If yes, please explain.
Does the Minor have any skin disorders, scaring or any other medical conditions that may affect the procedure or healing process?*
If yes, please explain.
PARENTAL CONSENT

I understand that piercings are a skin penetration procedure and involve risks, including infection, allergic reactions, and delayed/prolonged healing. I consent for my child to receive a piercing and confirm this decision is voluntary. I accept responsibility for supervising aftercare and ensuring instructions are followed to support safe healing and reduce risks. By submitting this form, I confirm I am the parent/legal guardian and I agree to the Booking Information/Terms & Conditions.
Signature of Parent/ Legal Guardian*

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Piercing Request Under 16yrs

Parent/ Legal Guardian Information

Minor Information

PARENTAL CONSENT