Known (potential) risks associated with body piercing
: Blood Poisoning (Septicaemia)
: Jewellery Embedding/Migration
: Localised Infection- Particularly Nose, Navel, Genitals
: Allergic Reactions To Jewellery Metals
: Localised Swelling & Trauma Around The Site
: Tongue Piercing May Lead To Swelling, Choking & Restriction Of The Airway
I declare that I give my full consent to body piercing being carried out by the aforementioned Operator. I confirm that potential complications, e.g. infection and swelling, gum/tooth damage, jewelry migration/embedding) for the procedure undertaken, and aftercare instructions have been explained to me. A written aftercare advice sheet containing more detailed information has been given to me and I agree that it is my responsibility to read this and follow the instructions on it until the site has healed. I confirm that the above information provided by me for this consent form is correct to the best of my knowledge, that I am over the age of consent for this procedure (i.e. 18 years old), and that I am not currently under the influence of alcohol or drugs
I consent that all of the intended procedure has been explained to me and that the information provided by me is correct to
the best of my knowledge. I hereby consent to my child, named above, having the body piercing and I understand the risks.
I have understood all the information given by the operator and agree to get my piercing done.