EAR PIERCING AND AFTERCARE 
RELEASE AND CONSENT FORM
FOR PERFECT PIERCING, NP 

 I the undersigned, hereby grant  Perfect Piercing NP (PPNP)  my consent to perform the earlobe piercing described above on the Customer. I hereby represent and agree that the Customer is not suffering (and has not in the past suffered) from diabetes, known allergies to disclosed piercing products, or any discoloration, swelling, lumps, or signs of irritation of the ear lobes or cartilage. I realize the importance of proper care in permitting the ears to heal without infection. I have read, understand, and promise to follow each step of the instructions on the PIERCING AFTERCARE sheet that has been provided to me. I acknowledge the importance of these instructions in maintaining healthy ears. Further, I understand that since PPNP will not have the opportunity to monitor my at-home aftercare, it is solely my responsibility to follow the PIERCING AFTERCARE instructions provided at the time of the ear piercing. I hereby agree to release and forever discharge and hold harmless the Piercer and PPNP and all its employees, directors and representatives from any and all claims, damages or legal actions arising from or connected in any way with the ear piercing, or the procedure and conduct use in the piercing. I certify that the Customer willingly submits to the ear piercing described above. I understand that I must carefully follow all instructions on PIERCING AFTERCARE provided to me. I agree to do so, and hereby release and forever discharge and hold harmless the Piercer,  PPNP, and all its employees, directors and representatives from any and all claims, damages or legal actions arising from or connected in any way with my failure to carefully follow all aftercare instructions. I grant permission and consent to PPNP for the use of the close up photograph of the piercing (not of recognizable face) completed for presentation under any legal condition, including but not limited to: publicity, copyright purposes, illustration, advertising, and web content. I understand that there should be no payment, royalties, or revocation for this release. I understand my piercings may become irritated and will require thorough daily cleaning. You must be 18 years or older to have your ears pierced without your parent’s consent. Your signature at the bottom indicates that you are over 18, or that you are the parent/legal guardian giving consent. I have read and agree to the terms above * Intake Form By submitting the intake form below and booking an appointment, I agree that Perfect Piercing NP,  has permission to pierce my/my minor's ears. I understand that despite our best efforts there is a risk of infection, allergy or imperfect placement and  Perfect Piercing NP,  is not to be held liable for any such outcome.