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Piercing Waiver


CONSENT


I hereby consent to Artists, Employees, Guest Artists or Agents of Nocturna Tattoo & Piercing to perform a body piercing. I agree that I have given the full oppurtunity to ask any questions I might have about body piercings. I do hereby acknowledge and agree to the following:


DEPOSIT POLICY

Deposits are up to the discretion of the individual artist and are non-refundable. Deposits are credited toward the final costs of the body piercing(s)/modification. Any cancellation, no-show or failure to appropriately reschedule within artists' policies will forfeit the deposit.


ACKNOWLEDGEMENT OF RISK

Nocturna Tattoo & Piercing takes all reasonable precautions for your safety. This includes observing commonly acknowledged and appropriate standards techniques, instruments, pigments and jewelry. Nocturna Tattoo & Piercing cannot guarantee against risks associated with performing piercings and body modifications.


I understand that the performance of creating a piercing/body modification is art. It is a creative process that can and often does vary from time to time. I assume the risk that the final product may vary in some minor ways from expectation. I accept this risk and consent to allow Artists, Employees, Guest Artists or Agents of Nocturna Tattoo & Piercing to perform the body piercing and/or body modification. I also understand that the performance of creating a body piercing is an invasive procedure. Despite all reasonable precautions for sanitization and safety, it may still result in serious medical complications, including but not limited to: infection, disease, pain, swelling, and scarring. To the extent provided by Utah law, I hereby hold harmless and indemnify Artists, Employees, Guest Artists or Agents of Nocturna Tattoo & Piercing from any and all causes of actions arising from physical harm caused by their acts and omissions. 

NO MEDICAL ADVICE

I understand that Artists, Employees, Guest Artists or Agents of Nocturna Tattoo & Piercing are not medical professionals. Any suggestion or advice from Artists, Employees, Guest Artists or Agents of Nocturna Tattoo & Piercing are those made by individuals and not medical advice. 


CLIENT RESPONSIBILITY FOR AFTERCARE

Aftercare instructions will be given by Artists, Employees, Guest Artists or Agents of Nocturna Tattoo & Piercing. Strict adherence to this advice is required to ensure the quality of any work, as well as to protect against known health risks. Length of healing process for each piercing varies and will be discussed at time of appointment.

Client acknowledges that client is solely responsible for following these instructions. Client also acknowledges that they must exercise their own proper aftercare of any piercings and body modifications. Client acknowledges they will follow the timeline instructed for aftercare to allow for proper healing. Client takes all responsibilities to contact Nocturna Tattoo & Piercing for any questions in relation to healing concerns or processes.

 

PERMANENT CHANGES

Client acknowledges that changes to the body are permanent. There may not be any reversal of certain services and Artists, Employees, Guest Artists or Agents of Nocturna Tattoo & Piercing have not expressed or implied that they are reversible.


MINOR PIERCING

I acknowledge that obtaining this piercing is my child's choice alone and will result in a permanent change to his/her/their appearance, and that no representation has been made to me as to the ability to later restore the skin involved in this procedure back to its pre-piercing condition. I acknowledge that I must be the legal parent or guardian for the minor receiving the procedure. I acknowledge that I must have proper identification for both myself and the minor.

I Agree

August 11, 2026

Please select who will be getting pierced
AdultMinor
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First Client Name
First Name*
Last Name*
Phone*
First Client Date of Birth*
Date of Birth
Information
Preferred name (optional)
Preferred pronouns (optional)
First Client Signature*
Client Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address
Email*
Confirm Email*
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Parent or Guardian's Driver's License / ID Card
Driver's License / ID Card Number*
Issuing State*
Which piercer/artist will be providing this service?
Type of Piercing
Type of piercing *
Do you give consent for photos and videos to be taken of your service? Photos may be used to aid in record keeping and may be used on artists’ and/or Nocturna's social media or for advertisement purposes.
Photos/videos may be used to aid in record keeping.*
Yes
No
Photos/videos may be used on social media or for advertisement purposes.*
Yes
No
Have you consumed food within the last two hours?
Yes
No
*Answering Yes to any of the questions does not necessarily preclude the person from receiving a body piercing/modification. Parent/Guardian answer to the best of your knowledge the questions for a minor.
Has a physician told you that you have hepatitis?
No
Yes
Have you been diagnosed with jaundice space (yellowing of the skin and eyes) in the last 10 days?
No
Yes
Are you prone to any fainting or lightheadedness?
No
Yes
Do you have diabetes?
No
Yes
Do you have any difficulty stopping bleeding?
No
Yes
Do you take any blood thinners?
No
Yes
Do you have any heart related problems?
No
Yes
Do you have high blood pressure?
No
Yes
Have you taken any drugs or had any alcoholic beverages in the last 8 Hours?
No
Yes
Have you consumed any anticoagulants in the last 24 hours? (Aspirin, Advil, Motrin, Ibuprofen, Aleve)
No
Yes
Are you pregnant?
No
Yes
Are you breastfeeding?
No
Yes
Do you have any skin conditions? Such as keloid or hypertrophic scarring, or psoriasis?
No
Yes
Do you have any known allergies?
No
Yes
If so, please list allergies
Do you have hemophilia?
No
Yes
Do you have any other conditions that may affect the healing of this body piercing?
No
Yes
If so, please state in box
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*
Last Name*
Relationship*
Phone*
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Date of Birth*
Date of Birth
Information
Preferred name (optional)
Preferred pronouns (optional)
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. I have read


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