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PIERCING CONSENT FORM

This is an agreement between the piercer and the client, indicating that full communication has taken place to ensure a legal, safe and successful body piercing.

First Name

Address

Last Name

Date of Birth

I am 16 years of age or older or have parental consent for this piercing

No

Yes

Allergic to nickel?

No

Yes

Initials

Today's Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

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FOUR SEASONS BEAUTIQUE

Shop BOO-21 Craigieburn Central, 340 Craigieburn Road Craigieburn Victoria 3064

(03) 9333 8782

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