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Jewelry Change-Out & Piercing Check-In Consent Form

This form is for existing piercings only and applies to jewelry changes, downsizing, removals, upgrades, or piercing check-ins.


This is not a new piercing appointment.

Birthday
Month
Day
Year

(example: nostril, helix, conch, navel)

Was this piercing originally done at Thirdeye Studio?
Yes
No
Service Being Done
Current Piercing Condition: Have you experienced any of the following?
Are you purchasing new jewelry from Thirdeye Studio today?
Yes
No – I am bringing my own jewelry
Do you have any medical conditions or are you taking medications that may affect your service or healing?
Yes
No

Examples include but are not limited to: diabetes, pregnancy, immune disorders, blood clotting conditions, skin conditions, or medications affecting healing.

Client Acknowledgment & Consent

By signing below, I acknowledge and agree to the following:

  • I understand that jewelry change-outs, downsizing, and piercing check-ins involve inherent risks, including but not limited to irritation, swelling, infection, migration, discomfort, or delayed healing.

  • I understand that existing piercings - especially those not originally performed at Thirdeye Studio, may have unknown history or trauma that increases risk.

  • I understand that Thirdeye Studio is not responsible for lost or damaged jewelry after installation or change-out, unless otherwise discussed prior to service. I understand that manufacturer warranties may apply to select fine jewelry only and do not cover loss or normal wear.

  • I confirm that I have disclosed all relevant medical information that may affect my service or healing.

  • I understand that Thirdeye Studio is not responsible for complications arising from undisclosed medical conditions, prior work performed elsewhere, or jewelry not purchased from the studio.

  • I agree to follow all aftercare instructions provided.

  • I release Thirdeye Studio, its owners, artists, and staff from liability related to this service.


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