WARPED ANATOMY PIERCING

Release and Hold Harmless Agreement

Must be completed BEFORE every appointment

 

I acknowledge by signing this agreement that I have been given the full opportunity to ask any and all questions which I might have about the obtaining of a body piercing and that all my questions have been answers to my full satisfaction.

I specifically acknowledge I have been advised on the facts and matters set forth below and I agree as follows:   

  1. I am not pregnant or nursing. I do not have epilepsy or hemophilia. I do not suffer from any heart conditions or take any medication which thins the blood. I have informed my Piercer of any condition such as diabetes that might interfere with the healing of the piercing.

  2. I acknowledge that infection is always possible, particularly in the event that I do not take proper care of my new piercing.

  3. I acknowledge receipt of aftercare instructions advising me of the proper care of my piercing and recognize the absolute necessity for following those instructions.  

  4. If I suffer from hepatitis or any other communicable disease, I have informed the Piercer of this fact and have been advised of any procedures necessary to promote the satisfactory healing of my piercing.

  5. I understand that a piercing exposes a person to infectious and non-infectious risks for the duration of the piercing’s healing time. These risks include but are not limited to:

  6. Medical or skin conditions such as keloid or hypertrophic scarring, bleeding, hepatitis, cysts, infections, rashes, or lesions at the site of piercing.

  7. I have advised the Piercer of any allergies to metals, latex gloves, soaps, and medications. I acknowledge that it is not responsibly possible for the piercer to determine whether I might have an allergic reaction to the piercing or process involved and acknowledge that such a reaction is possible.

  8. I am not under the influence of drugs or alcohol. To my knowledge, I do not have any physical, mental or medical impairment or disability which might affect my wellbeing as a direct or indirect result of my decision to have a piercing done at this time.

  9. I acknowledge that obtaining this piercing is my choice alone and will result in a permanent change to my appearance.