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Date of Birth
اليوم
الشهر
السنة
Did you ate very well at least 4 hours before the appointment?
Yes
Please select the diagnosed conditions you have:
  • I Agree to give my full consent to body piercings carried out by the body piercer


  • I Agree that I am responsible for the any touch-up work due to my fault or carelessness.


  • I understand that I will be pierced using the appropriate instruments and sterilisation processes.


  • I understand that the needle used during my piercing is pre-sterillised and is single use only.


  • All jewellery used is that of high quality, Implant-Grade Titanium (Grades 6al4v & ASTM F136) only, bought exclusively from reputable suppliers.


  • I Agree that both the Piercer and Studio will give me instructions of how to take care of my piercings while it's healing and I will follow them and they will given me the full opportunity to ask any and all questions about the piercing procedure and will answered these questions to my total satisfaction


  • I am informed about possible side effects and complications of body piercing procedures such as infection and swelling particularly if I do not follow the instructions given to me.


  • I been fully informed of the inherent risks, associated with getting a piercing. I fully understand that these risks, known and unknown can lead to injury, including but not limited to infection or scarring. I have been informed of the potential risks associated with getting a piercing, I still wish to proceed with the piercing and I freely accept and expressly assume any and all risks that may arise from piercing


  • I understand and agree that it is my responsibility to read and follow the instructions about procedures and aftercare.


  • I Agree that I am voluntarily getting a piercing without duress.

    I further affirm that I do not have diabetes, epilepsy, hemophilia, a heart condition and I don't take blood thinning medication.


  • I do not have a medical or skin condition that may interfere with the procedure or healing of the piercing.



    Note: Having diabetes doesn't mean you can't have a piercing. But your blood sugar levels must be in range before you do. If they aren't, your piercing might not heal properly or quickly, and risk getting an infection. Your blood pressure should also be stable to stop these problems



    At the end of your appointment we will provide you with PDF aftercare instructions (via Whatsapp).

    I understand If I experience any abnormal symptoms or have concerns about my piercing, I will contact AYEPIERCING immediately for their professional advice. If unable to contact AYEPIERCING, I will seek medical advice immediately.



    We are always on hand to offer full support


ID Type
Saudi ID
Resident ID
Visit ID

I Agree to everything written above and by signing this consent form, I hereby release AYEPIERCING it's employees from all manners of liabilities, claims, actions and demands in law or in equity

Single choice
Agree

The undersigned Client desires to receive body piercing at:

AYEPIERCING

(The Studio) located at:

Almurjan, Jeddah

Body Piercing Specialist:

Abrar bin kuddah alkathiri

©2018 by AYEPIERCING

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