HIPPIE HOOPS AND HOLES PIERCING CONSENT
I acknowledge by signing this release I have been given the full opportunity to ask any and all questions which I might have about obtaining a piercing from Hippie Hoops and Holes LLC, and all my questions have been answered to my full and total satisfaction. I acknowledge I have been advised of the matters set forth below and I agree as follows:
- I am not pregnant. I will discuss with my piercer if I am breastfeeding. If I have any condition that might affect the healing of this piercing, I will inform my Piercer.
- I do not suffer from medical or skin conditions such as, but not limited to, keloid or hypertrophic scarring, psoriasis at the site of the piercing or any open wounds or lesions at the site of the piercing.
- I have advised the Piercer of any allergies to metals, latex gloves, soaps, and medications. I acknowledge it is not reasonably possible for the Piercer to determine whether I might have an allergic reaction to the piercing or processes involved in the piercing and further acknowledge that such a reaction is possible.
- I have trustfully represented to the Piercer I am over the age of 18 years. I am not under the influence of drugs or alcohol. To my knowledge, I do not have any physical, mental, or medical impairment or disability which might affect my well-being as a direct or indirect result of my decision to have a piercing done at this time.
- I acknowledge that obtaining this piercing is my choice alone and will result in a permanent change to my appearance and/or use of bodily function, and that no representation has been made to me as to the ability to later restore the skin/tissue/muscle involved in this piercing to its pre-piercing condition. Piercings can cause trauma and problems. I have done my research and decided to go forth with said piercing and will ask my piercer if I have any questions or concerns.
- I acknowledge infection is always possible as a result of obtaining a piercing. I have received aftercare instructions and I agree to follow all of them while my piercing is healing.
- I understand I will be pierced using appropriate instruments and sterilization.
- I have eaten in the last 4 hours and will let my piercer know if I feel dizzy, lightheaded, or nauseated throughout the piercing process, even up to exiting the building.
- I understand this piercing may take up to a year to heal thoroughly. I agree to release and forever discharge and hold harmless the Piercer and all employees from any and all claims, damages or legal actions arising from or connected in any way with my piercing, or the procedure and conduct used in my piercing.
March 3, 2024