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Piercing Consent Form

Health Declaration

Please read & fill out the entire form.

This is an agreement between the piercer and the client, indicating that full communication has taken place to ensure a legal, safe, and successful body piercing.

Statements Of Consent

I have truthfully represented to Amonara Creations that I am over 18 years of age or have my parent/ guardians consent.

I have eaten within the past 4 hours.

I have not drank alcohol within the past 8 hours.

If I have provided my own jewelry, I take full responsibility for how my body reacts with the metal.

I understand my piercer cannot be held responsible if my body reacts negatively to the metal of the jewelry.

I understand that my piercer's suggestions are not medical advice.

I understand I am responsible for looking after my piercing.

I understand sterilized jewelry and equipment and/ or single use disposables will be used for my piercing.

This is to certify that I, the above named and undersigned, do give my permission to be pierced at Amonara Creations.

I am fully away of and take full responsibility for the piercing process, the healing, and the daily aftercare procedure.

By signing this form, I agree to the statements of consent & that all information is truthful and accurate.

Please upload a copy of your ID.
Other Form of ID (If Applicable)
Parent/ Guardian's ID

Thanks for submitting!

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