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Permanent Cosmetics FAQ’s
Medical Spa FAQ’s
Cancellation and Rescheduling Policy
Patient Consent Forms
Minor Child Piercing Release
the parent/legal guardian of
to pierce my son's/daughter's________ and in considerations of its doing so, I hereby release NAKED FACE SPA & COSMETICS and its employees and agents, from all manner of liabilities, claims, actions and demands, in law or in equity, which I or my heirs have or might have now or hereafter by reason of complying with my request to be pierced.
I FULLY UNDERSTAND THAT ANY EMPLOYEE or agent of NAKED FACE SPA & COSMETICS , when performing body piercing, does not act in the capacity of a medical professional. The suggestions made by any employee or agent of NAKED FACE SPA & COSMETICS, are just suggestions. They are not to be construed as or substituted for advice from a medical professional.
I understand my SON/DAUGHTER WILL BE PIERCED using appropriate instruments and techniques. To ensure proper healing of the piercing, we agree to follow the aftercare procedures outlined in the aftercare Instructions" sheet, until healing is complete. I understand that this type of piercing usually takes_____________ or longer to heal.
BY MY SIGNATURE BELOW, I certify that I am the parent/legal guardian of _________________ who is at least___________ years old, and also willingly submits to these procedures, with a full understanding of possible complications such as but not limited to infection, allergic reaction, or rejection of the piercing.
MY SON/DAUGHTER AND I HAVE RECEIVED A COPY OF THE "AFTERCARE INSTRUCTIONS'' SHEET, which we have read and fully understand and hereby assume full responsibility for aftercare and cleanliness for my son/daughter. I understand that by having this piercing performed my son/daughter is making a permanent change to his/her body and no claims haxie been made regarding the ability to undo the changes made
Have you eaten with the last 4 hours?
Have you have any alcoholic beverages in the last 8 hours?
Are you prone to fainting?
Are you prone to heavy bleeding?
Have you taken aspirin, ibuprofen or anticoagulants with in the last 24 hour
Have you have any allergies?
If yes, please list
Are you pregnant?
Do you have any conditions which might affect the healing of this piercing?
How did you hear about
City, State & ZIP
By my signature below I certify that I am the parent or leta,a1 guardian of the above named person . I Further understand that if I gave False information or produce false documents stating my name and age to be other than correct, then I am liable for prosecution.
Minor Signature (Piercee)
Select a date
Date of Birth
I acknowledge that the sterilization procedures used were explained to my full satisfaction and f had the opportunity to ask any question regarding these procedures. Both written and verbal aftercare instructions were provided to me,
Day of Week
Time of Day
Thanks for submitting!
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