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Lyzz Lynx LLC

Custom Welded Permanent Jewelry

Permanent jewelry is a process that involves the use of a TIG pulse arc welder to weld the jewelry together while on your body. The procedure is usually painless and is performed with your safety in mind. This consent form is intended to inform you of the risks of the procedure and to obtain your informed consent for the procedure.


I understand that if I have a pacemaker, or any other medical equipment that may be interfered with by welding equipment, I have checked with my physician before proceeding. I have informed my doctor that permanent jewelry might expose me to 4-7watts, but up to as many as 30watts, of power.



I understand that although rare, an allergic reaction to the jewelry can occur.

I understand that the welding procedure does have some risks, including but not limited to potential shock, allergic reactions, irritation, discomfort, burns, and scarring.


I agree to the jewelry care instructions recommended by the technician. I have been informed that discoloration of the jewelry or my skin can depend on many factors including personal pH, exposure to lotions, self tanning or other chemicals or metal abrasion (most commonly with anklets). This is not my skin reacting to the metal but rather metal reacting to its environment.

I understand that there may be some instances where I will be required to remove my jewelry, including but not limited to medical procedures like MRI and surgery. I understand that the jewelry can be easily removed with scissors or metal snips at the weld point and reattached by the jeweler at a later date.

I understand that Lyzz Lynx LLC is not responsible for misplaced, lost or broken chains as it is impossible to know how or why it came off. I have been encouraged to take extra care when wearing my jewelry and to contact Lyzz Lynx LLC immediately if I have any issues or concerns. If the permanent jewelry is lost within 30 days of purchase, a new piece can be purchased with a 10% discount.


I understand that if my chain does break on the weld at any time, that it can be rewelded for free. However, if the chain breaks due to misuse or neglect, the artist reserves the right to charge a fee for repair or replacement. Chain must be presented to show where break occurred. It's permanent jewelry, not indestructible jewelry. 

I understand that all sales are final. Custom pieces cannot be exchanged once welded. 



Acknowledgement and Consent

I completed the above form to the best of my knowledge. I have had the opportunity to ask any questions and have received satisfactory answers. I understand the risks and potential side effects associated with the permanent jewelry procedure. I understand that the results of the procedure are not guaranteed and may vary from person to person. I am over the age of 18 and consent to the procedure. I will not hold the technician/jeweler liable for any issues not disclosed at the time of my service or any adverse effects from the permanent jewelry procedure. This agreement remains in effect for this procedure and any follow up appointments.


February 2, 2026

First Client's Name
First Name*
Last Name*
Phone*
First Client's Age Acknowledgment*
First Client's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Client's Signature*
Second Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Third Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Fourth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Fifth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Sixth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Seventh Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Eighth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Ninth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Tenth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Media Permission
I give the technician/jeweler permission to photograph my jewelry and procedure for their own marketing and promotional purposes.*
No
Yes

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.

Minors under the age of 13 will be offered a complimentary clasp in lieu of Permanent Jewelry. 



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*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
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.


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