Loading...

This consent form is to provide general information to clients before an ear or nose piercing session, offer expectations, and after care instructions. Minors (under 18) must have a parent/guardian provide consent and be present the entire time of the session. If you have any questions about the consent form or the piercing appointment, please contact me at jenny@jennyfromthebronze.com, via phone/text or my Facebook page

Cancellation Policy: Cancellations must be received 24 hours prior to the appointment. A cancellation less than 24 hours prior to the appointment is subject to the cancellation fee outlined on my booking website. A no-show or cancelling less than 12 hours prior to the appointment is subject to be charged the full rate of the service(s) booked.

Payment/Booking: A credit card is required to hold and reserve your appointment but will NOT be charged for the appointment itself unless the cancellation fee/no show fee is required. Cards are NOT held on file to charge after the appointment unless client specifically selects the option to save the card on file. Payment methods accepted are cash, card, venmo, and zelle.


MINORS: A parent or legal guardian MUST be present for any client under the age of 18. If an adult (parent or guardian) is not present, service cannot be performed. Appointment will be considered a no-show and client will be charged the rate of the appointment per the cancellation policy. and paste the body of your waiver here. A form of ID is required of the minor. This can be a birth certificate, passport, state issued ID. Additionally, parent must present a photo ID at the time of appointment, and last 4 digits of drivers license will be logged into Release Authorization form as required by law. Nose piercings are not performed on any child under the age of 14.

With minors, in addition to required parental consent, it is highly recommended to check with school policies regarding nose piercings to ensure the nose piercing can be worn at school.

INFANTS: We do offer ear piercing for infants in the earlobe only. Infant should be at least 8 weeks old and received the first DPT vaccination. It is recommended to discuss with your pediatrician prior to deciding to pierce your child's ears, although we only require parent/legal guardian consent on our end. Birth certificate for child and proper photo ID for parent is required.

Ear piercing is the piercing of the ear lobe or outer cartilage are of the ear.We do not offer tragus, conch, rook, daith, or industrial piercings. Nose piercing pierces the side of the nose on the nostril area and excludes piercing the septum. A hand pressured medical grade device is used along with a high quality metal stud (ie, titanium, surgical steel, stainless steel) for both ear and nose piercings.

It is important to adhere to your aftercare instructions to ensure proper healing and prevent infections. As you will have a foreign object in your body, there is a possibility your body may reject it. Persistent redness or swelling indicates an infection or that your body cannot tolerate a foreign object. We use the best quality metal to reduce the risk, and we provide sanitized and sterilized products during the piercing.

For earlobe piercings, the earring must stay in for 6 weeks minimum. Cartilage piercings on the ear must remain in the ear for 12 weeks, and nose piercings must remain in the ear for 12 weeks. During the first 6 months following an earlobe piercing, you cannot go more than 24 hours without an earring in place. For nose piercings, you cannot go any amount of time without a nose ring in place. When you switch out piercings, it must be done immediately after the current one in the ear is removed.

Ear piercings:

  • Always wash hands before touching your piercing
  • Cleanse the ear front and back with the provided antiseptic cleanser 3 times daily, and turn the earring completely 3 times daily.
  • DO NOT remove earrings while cleansing and turning.
  • Keep the pierced area clean and dry, especially after swimming and exercise. Immediately cleanse after using shampoo, hair products, spraying cologne. Try to keep hair away from piercing as much as possible during healing time.
  • Take extra care when removing clothing or brushing hair so earrings do not get caught.
  • For cartilage piercings: during the first 6 months, do not leave earrings out for any length of time. When an earring is removed, immediately replace it.

Nose piercings:

  • Always wash hands before touching your piercing
  • Cleanse piercing with clean cotton sway and provided antiseptic cleanser at least 2 times a day on the outer area of your nose where the piercing is.
  • Turn the stud completely around 2 times a day. DO NOT remove stud while cleaning or turning.
  • Keep piercing clean, and dry, especially after swimming or exercise. Cleanse after swimming, exercise.
  • Take extra care when washing your face as stud can accidentally get pulled out.
  • If stud comes out, sanitize it and put it back in immediately. Gently hold down your stud with clean fingers when blowing your nose.
  • I recommend a small round bandaid to cover your nose stud at night to keep it clean and aid in healing. Make sure the sticky part of the bandaid does not touch the stud or it might pull it out when removing the bandaid.
  • For the first 6 months after piercing, do not leave stud out of nose for any period of time.


You may experience, pain, redness, or swelling the first 24 hours after an earlobe piercing. If you experience this longer than 24 hours, seek medical attention immediately.

If you experience pain, redness or swelling after the first 24 hours of any piercing (ear/nose), immediately remove the stud and seek medical attention.

Nose piercings and cartilage piercings carry a greater risk of infection or complications due to improper care of piercing.

Client will receive an aftercare kit that includes complete care instructions and piercing cleaner at the appointment. Be sure to follow aftercare instructions. Please note that this form does not include complete aftercare instructions, and you will be given that to take home at your appointment.

NOTE: My piercings are sterilized and in single-use, sealed packaging right up until the piercing will begin. If a client (minor/adult) changes their mind before the piercing and after I have opened the piercing kit, client is responsible for the payment of the earring/stud as I can not use it on another client. Fee for appointment will be due regardless of completion of piercing if the piercing kit has been opened.

If you have any questions prior to your appointment, please contact me.

If you have questions, please text me at 832-861-2236, email me at jenny@jennyfromthebronze.com, or message me on social media. You may also leave a voicemail so I can get back with you when I am not with a client or traveling to/from a client appointment, and within business hours. Fastest responses are usually available through text or email.

By signing and submitting this waiver, you agree you have thoroughly read through this document, understand it, and agree to follow all appointment guidelines and aftercare instructions.

Please download a copy of this form once this has been emailed to you so you can save it for future reference.








Do you have any questions/comments to add?

Enter questions, comments, notes here
How did you hear about Jenny From The Bronze?

Referred by: facebook/instagram/google search, friend, etc
Are there any special instructions or considerations to get to your home? For example: gated community, apartment complex, parking instructions for apartments or offices, or you're on the 2nd or higher floor in an apartment? Please give clear instructions as needed to help me get to you. Please note that on floors 2 and above, there must be safe and easy access for me to get to you while carrying the equipment/supplies needed for your appointment.

Special Instructions: gated area, apartment, parking etc
First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Signature*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Signature*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Signature*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Signature*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Signature*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Signature*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Signature*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Signature*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Signature*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!