• Permanent Jewelry Consent and Waiver

    Linked by Jessica Sanborn LLC
  • Date of Birth*
     / /
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.

  • Consent and Waiver

    PERMANENT JEWELRY IS A PROCESS THAT INVOLVES THE USE OF A WELDING MACHINE TO WELD THE JEWELRY TOGETHER WHILE ON YOUR BODY. THE PROCESS IS PAINLESS AND IS PERFORMED WITH YOUR SAFETY IN MIND. THIS CONSENT FORM IS INTENDED TO INFORM YOU OF THE RISKS OF THE PROCESS AND OBTAIN YOUR INFORMED CONSENT FOR THE PROCESS. PLEASE CONFIRM THE FOLLOWING QUESTIONS AND SIGN BELOW THE SECTION TO CERTIFY THAT YOU CONSENT TO THE USE OF A WELDING MACHINE AND HAVE BEEN INFORMED OF ANY RISKS AND THAT YOU HAVE DISCLOSED ANY KNOWN HEALTH RELATED RISKS.
  • I understand that although rare, an allergic reaction to the jewelry can occur.*
  • I do not have a pacemaker. Welding with pacemakers is very dangerous and should not be performed. Please ask the welder for a clasp instead.*
  • I understand that the welding process does have some risks, including but not limited to potential allergic reactions, irritation, discomfort, burns, and scarring.*
  • 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 and other factors.*
  • 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 scissors and re-attached by the welder at a later date for a welding fee.*
  • 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 scissors and re-attached by the welder at a later date for a welding fee.*
  • I give the technician/jeweler permission to photograph my jewelry and process for their own marketing and promotional purposes.*
  • I understand that if my jewelry breaks at the weld site within one year of placement, Linked by Jessica Sanborn LLC will re-weld free of charge. I understand that if the jewelry breaks at any other site, the piece can be rewelded for a reweld fee.*
  • I understand that Linked by Jessica Sanborn LLC does not offer any refunds as jewelry is custom fit to each specific individual.*

  • I agree to the following policies:
    Tarnish Replacement Policy: 

    • Within 30 Days: If your chain tarnishes and is unable to be cleaned with fomaning cleanser or the provided polishing cloth, we will provide a
      replacement with the same chain or one of equivalent value
      at no additional cost. 
    • 30-90 Days: We offer a replacement chain at a 50% discount and will make every effort to make the situation right. 
    • Beyond 90 Days: Customers will be responsible for the full
      replacement cost, and no refunds will be provided.
    • The above listed policy is null and void if the tarnish is due to lack of care steps taken from the provided care card, such as tarnish from lotion, self tanner, etc. 

    Photo & Video Consent Policy:

    • I hereby give permission to Linked by Jessica Sanborn LLC and its employees to capture photographs or videos of me, including my likeness
      and overall appearance during my visit/appointment.
      I understand that these photographs and videos may be utilized
      for promotional and marketing purposes, including but not limited
      to social media, websites, printed materials, and other marketing platforms. I acknowledge that Linked by Jessica Sanborn LLC has the
      right to edit and use these photographs and videos as they deem
      appropriate.
    • I also understand that I will not receive any form of compensation
      or financial remuneration for the use of these photographs or
      videos.
    • I recognize that once the photographs or videos are published,
      Linked by Jessica Sanborn LLC cannot control the use of these images by
      third parties, who may utilize them for their own purposes.
      I release and discharge Linked by Jessica Sanborn LLC, its owners, and
      employees from any and all claims, demands, or causes of action
      that may arise from or be connected to the use of the photographs
      or videos.
    • I hereby confirm that I have read and fully understand the terms
      of this consent form, and I have had the opportunity to ask any
      questions before signing.
    • By signing this form, I certify that I am at least 18 years of age. If
      under 18 years of age, a parent or legal guardian must sign this
      consent form.

    Permanent Jewelry Assurance Policy:

    The term “permanent” as it relates to welded jewelry may not always be guaranteed due to normal wear and tear as well as other unforeseen accidents. To provide peace of mind, we have established the following assurance policy.

    • Terms of Purchase - At time of Purchase:
      • Each piece is custom-made by a certified welder, and all sales are
        final once payment is completed. Due to the personalized nature of each piece, exchanges or refunds are not available after the sale is finalized.
    • Permanent Jewelry Rewelding Policy:
      • Our permanent jewelry comes with a one year limited warranty from the date of placement. The warranty covers defects in materials or workmanship under normal wear and proper care. The warranty does not cover damage caused by improper care, negligence, accidents, or unauthorized modifications. If the jewelry breaks at the site of connection, please contact for reweld. Reweld warranty will be honored for up to one year from date of placement.
    • Customer Satisfaction Policy:
      • Upon completion of the install, customers will have their piece photographed at the weld site. The customer will sign off that their piexce was completed to their satisfaction, indicating that they are leaving their appointmet with a piece that has been welded with the finest craftsmenship. 
      • If the customer is dissatisfied, Linked by Jessica Sanborn LLC will do everything possible to rectify the dissatisfaction by addressing the concerns of the customer. If the customer is still dissatisfied by the service and there is no resolution, Linked by Jessica Sanborn LLC will retain all materials and the customer will not be charged for the appointment. 
    • Additional Care Policy:
      • We recommend an annual check-up on your permanent jewelry. Linked by Jessica Sanborn LLC offers a complimentary inspection and cleaning service within the first year of purchase to ensure your piece remains in the best possible condition.
      • Each Linked by Jessica Sanborn LLC Permanent Jewelry customer will receive a Care Kit upon completion of their installation. Inside, custoners will find a Care Card with instruction of how to care for their new piece of jewelry, a polishing cloth, and contact information for Linked by Jessica Sanborn LLC, as well as a loyalty card and friend referral card for a furtur discounted purchase. Customers are required to adhere to the care instructios on the Care Card for policies and warantee to remain in effect.

  • ACCEPTANCE

    I have read and agree to the terms of this consent form, including the policies listed, I have had the opportunity to ask questions and have received satisfactory answers. I understand the risks and potential side effects associated with the permanent jewelry process. I understand that the results of the process are not guaranteed and may vary from person to person. I am over the age of 18 and consent to the process. If I am under the age of 18, a parent or guardian must sign. I will not hold the permanent jewelry artist, welder, or Linked by Jessica Sanborn LLC liable for any issues not disclosed at the time of my service or any adverse effects from the permanent jewelry process. By signing the consent form, this agreement remains in effect for this procedure and any follow-up appointments.
  • *

  • WAIVER OF LIABILITY

    I hereby expressly waive and release any and all claims, now known or hereafter known, against Linked by Jessica Sanborn LLC and its employees, owner, and company (to be referred to as "Releasees") on account of personal or psychological injury, illness, pain, suffering, temporary or permanent disability, death, property damage, or financial loss arising out of or attributable to my participation in the procedure to obtain permanent jewelry, whether arising out of the ordinary negligence of Linked by Jessica Sanborn LLC or any Releasees or otherwise. I agree not to make or bring any such claim against Linked by Jessica Sanborn LLC or any other Releasees affiliated with Linked by Jessica Sanborn LLC, including Jessica Sanborn herself, and forever release and discharge Linked by Jessica Sanborn LLC and all other Releasees from liability under such claims. This waiver and release do not extend to claims for gross negligence, willful misconduct, or any other liabilities that Connecticut law does not permit to be released by agreement.
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  • Date*
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    2 digit month, 2 digit day, 4 digit year
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