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Body Piercing Consent Form Template

Streamline Your Body Piercing Consent Process

Collecting consent is crucial when it comes to body piercing, yet it's often a process that feels daunting. This body piercing consent form template helps you effortlessly gather essential client information and obtain the consent you need for safe procedures. With this template, you can document health conditions, clearly outline aftercare instructions, and minimize legal liabilities, all while ensuring compliance with regulations. Plus, it's easy to customize to suit your studio's needs. Start using the live template today and protect your clients.

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Client full legal name
Date of birth
Are you at least 18 years old?
Yes
No
Email address
Mobile phone number
Government ID type
Driver license
Passport
State/Province ID card
Military ID
School ID (minor)
Prefer not to say
Other
Please Specify:
Emergency contact full name
Emergency contact phone
Relationship to you
Piercing location(s) requested
If other/custom location, specify
Side or placement preference
Left
Right
Both
Not applicable
Preferred jewelry material
Implant-grade titanium (ASTM F-136)
Niobium
14k/18k gold (nickel-safe)
Implant-grade stainless steel (ASTM F-138)
PTFE/Bioplast
Other/Unsure
Preferred jewelry style
Stud
Ring/Hoop
Straight barbell
Curved barbell
Captive bead ring
Clicker
Other/Unsure
Have you experienced any of the following with past piercings?
Infection
Rejection or migration
Keloid or raised scarring
Allergic reaction to jewelry
Prolonged bleeding
Fainting or dizziness
None of the above
Do you currently have an illness, fever, cold/flu, or an infection near the piercing area?
Yes
No
Are you pregnant or breastfeeding?
Yes
No
Not applicable
Prefer not to say
Do you have any of the following medical conditions?
Are you currently taking any of the following medications?
Blood thinners (e.g., warfarin, aspirin)
Immunosuppressants
Steroids (oral or high-dose)
Accutane/isotretinoin (past 6 months)
Antibiotics (current course)
None of the above
Do you have any allergies or sensitivities?
If other allergies or sensitivities, describe
Are you under the influence of alcohol or drugs today?
Yes
No
I understand that body piercing involves risks including bleeding, infection, scarring, migration/rejection, nerve damage, and allergic reactions, and that results may vary.
Yes
No
I understand this procedure uses sterile, single-use needles and properly sterilized jewelry and equipment.
Yes
No
I have received aftercare instructions and agree to follow them.
Yes
No
Photo consent
No photos
Photos for my client record only
Photos may be used for marketing; obscure identifying features
Photos may be used for marketing; identifying features okay
Parent/guardian full name
Relationship to minor
Parent/guardian phone
Parent/guardian government ID type
Driver license
Passport
State/Province ID card
Military ID
Prefer not to say
Other
Please Specify:
I am the legal parent or guardian of the minor and have authority to consent for this procedure.
Yes
No
I agree that the studio may store my information for legal and record-keeping purposes.
Yes
No
Preferred follow-up contact method
Email
Phone call
Text message
Any
Do not contact
I acknowledge there is no guarantee of specific results and that service fees are nonrefundable once the procedure is performed.
Yes
No
Type your full legal name as your signature
Date of signature
Parent/guardian typed name as signature (if applicable)
Parent/guardian signature date (if applicable)
I give my consent to perform the body piercing described in this form.
Yes
No
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Paper art illustration featuring a body piercing consent form template for a body art article

When to use this form

Use this form whenever you take a booking for a new or returning client, for ear, nose, oral, or body piercings. It captures age verification, IDs, health history, allergies, and aftercare consent, so you can make safe choices and document approval. Have clients complete it on a tablet at check-in or send it ahead to cut wait time. If you also provide aesthetic services, keep your process consistent with the Botox consent form. When you plan to request follow-up feedback or healing photos, pair your workflow with a Survey consent form to record permission. The result: clearer expectations, fewer complications, and a signed record that protects your studio and your clients.

Must Ask Body Piercing Consent Questions

  1. Are you at least 18 years old, or do you have a legal guardian to consent?

    This confirms legal capacity to authorize the procedure and flags when a guardian must sign. It protects you from invalid consent and helps you follow local laws.

  2. Do you have any medical conditions, allergies (including metals or latex), or medications that may affect bleeding or healing?

    This guides safer choices or a decision not to proceed if risk is high. It captures critical details like blood thinners, keloid history, or nickel sensitivity to prevent complications.

  3. Which body site are you piercing, and what jewelry material and size do you approve?

    Documenting the exact site and materials sets a clear scope, pricing, and expectations. It also ensures biocompatible options that support healthy healing.

  4. Do you understand the procedure, risks, aftercare steps, and agree to follow them?

    This confirms informed consent and encourages adherence to aftercare, which reduces infections and rework. For help framing risks in plain language, see the Therapy informed consent form.

  5. Do you consent to photographs for records or marketing, and how may we use them?

    Clear photo permissions protect privacy and define allowed uses (records only, website, or social). It prevents misunderstandings and provides visual evidence of condition at the time of service.

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