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MAXIMUM DOSAGE

Piercing Consent Form

I acknowledge by signing this agreement that I have been given the full opportunity to ask any and all questions which I might have about the obtaining of a piercing and that all of my questions have been answered to my full satisfaction. I specifically acknowledge I have been advised of the facts and matters set forth below and I agree as follows.

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If I have diabetes, epilepsy, hepatitis, haemophilia, HIV-AIDS or any other communicable disease, heart condition or take medicine which thins the blood I have advised my piercer.
I do not have medical or skin conditions such as but not limited to: acne, scarring (Keloid) eczema, psoriasis, freckles, moles or sunburn in the area to be pierced that may interfere with said piercing.
I acknowledge it is not reasonably possible for the representatives and employees of Maximum Dosage to determine whether I might have an allergic reaction to the jewellery or processes used for my piercing, and I agree to accept possible reactions.
I acknowledge that infection is always possible as a result of the obtaining of a piercing, particularly in the event that I do not take proper care of my piercing. I have received aftercare instructions, I agree to follow them while my piercing is healin
I acknowledge that a piercing can make a permanent change to my appearance. To my knowledge, I do not have a physical, mental or medical impairment or disability which might affect my well being as a direct or indirect result of my decision to have a pier
I consent to the application of the piercing and to any actions or conduct of the representatives and employees of Maximum Dosage, reasonably necessary to perform the piercing procedure.
I am not pregnant or nursing.
I am not under the influence of alcohol or drugs.
By signing this consent form, you are irrevocably giving permission to Maximum Dosage employees to take and use photographs, video and voice recording. This is completely voluntary and up to you. Your consent to the use of the photographs and video

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Input your full name, as spelt above, to form a digital signature.

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