CONSENT TO PROCEDURE AND RELEASE OF LIABILITY I now authorize Perry Doig, Kristina Outland, Frank Troeh, Manny Leon Guillen, Brooke Bittens or any representative body piercer at Rose Gold's Tattoo & Piercing to perform the procedure of piercing upon myself. I understand that this piercing(s) usually takes 3-6 months or longer to heal and that healing times vary from person to person. - This procedure is to include whatever is required in attempting to accomplish such purpose and if any conditions are revealed during this procedure that were not recognized before, and which call for procedures in addition to or different from those originally contemplated, I further request and authorize the performance of such procedures.
- The nature and purpose of this procedure, possible alternative methods, the risk involved, and the possibility of complications have been fully explained to me. I acknowledge that no guarantee or assurance has been made as to the results that may be obtained, and I assume any and all risks in connection therewith.
- I understand this procedure involves the invasion of my body by an instrument and jewelry, and said instrument and all other instruments used in the course of this procedure are sterile, and that this procedure will be done using strict aseptic technique.
- It has been explained to me that jewelry made of 14-karat gold, surgical stainless steel, niobium, or titanium is ideal for this procedure and I have made the decision to use jewelry made of 14-karat gold, surgical stainless steel, titanium, or glass and I accept all responsibility for this decision.
- I hereby certify that I am not being coerced in any way, and I am requesting this procedure of my own free will.
- I understand that the needles used for this procedure are single-use. They have not been used on any other clients. The needles, furthermore, have been autoclaved prior to use and are safely and properly disposed of after each client.
- I acknowledge that certain medical conditions and treatments may be adversely impacted by the procedure(s) of this piercing. Such medical conditions include but are not limited to, impaired kidney and/or liver function, diabetes, jaundice, medication containing blood thinners, and medication that weakens the immune system.
- I acknowledge it is not reasonably possible for the representatives and employees of this shop to determine whether I might have an allergic reaction to the processes used in my piercing and I agree to accept the risk that such a reaction is possible.
- I understand and agree to the aftercare suggestions that were provided to me via paper copy.
- I understand that it is not suggested to get pierced before traveling, especially hiking/camping or swimming of any kind, and that I should refrain from these activities until the piercing is fully healed.
- I understand that it is not suggested to get pierced if I play sports including contact sports or competitions that would require me to remove my jewelry and that jewelry should not be removed or covered with bandages at all until fully healed. Additionally, competitive sports that may cause my piercing to be hit or snagged should be avoided until the piercing is fully healed.
- I understand and accept that jewelry is final sale, there will be no refunds or exchanges on jewelry once the jewelry is inserted into my body. I understand that once jewelry is inserted into my piercing, I am obligated to pay for the jewelry in its entirety. I understand that it is my responsibility to ask for the price of jewelry before it is inserted into my piercing and agree to pay for the jewelry in full. Furthermore, I understand that jewelry should be cared for with daily maintenance and Rose Gold's Tattoo & Piercing will not be liable for lost or broken jewelry under any circumstance.
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