thePiercing Parlour — New Client Intake
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1
You
2
Piercing
3
Health
4
Sign
Step 1 of 4

Tell us about you.

Basic information so we can keep your records safe and reach you if needed.

— ID & age —
Step 2 of 4

What are you getting?

Pick the category and tell us the placement so your piercer is ready.

Titanium is the default for fresh piercings — especially with nickel sensitivity.
Step 3 of 4

Health & safety.

Honest answers here give you the safest piercing. We ask every client.

— Allergies & meds —
Eating first prevents dizziness or fainting at the chair. It matters more than you'd think.
Leave blank if none. Blood thinners are especially important to note.
Step 4 of 4

Review & sign.

Read each statement, check the box, then sign with your full name.

Risks & aftercare agreement.

I understand body piercing carries risks including infection, allergic reaction, scarring, and rejection. All health information I've provided is accurate. I agree to follow aftercare instructions — regular sterile saline cleaning, avoiding submersion, trauma, and cosmetics on healing piercings.

Age & identification.

I confirm I am 18 or older — or accompanied by my legal guardian as declared — and any identification I present is valid and belongs to me or my guardian. The Piercing Parlour reserves the right to refuse service if ID cannot be verified.

Photo & media.

The studio may photograph the finished piercing for portfolio or studio social use. Faces are blurred or cropped by default. I can opt out below; opting out has no effect on my appointment.

Received · sent to the studio

Thank you, and welcome.

Your intake is at the front desk. Show this confirmation when you arrive — Nicole or Victoria will pull your file and bring you to the chair.

Confirmation
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