(909) 981-2877
upland@laughingbuddhabodypiercing.com
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Laughing Buddha After Piercing Release Form

Thank you for choosing Laughing Buddha for your procedure today. We sincerely hope you had a pleasant experience today. Please have your ID handy and complete the following form. For security, the contents of your submission will be emailed to our staff and not stored on our web server.





Release

I declare under penalty of perjury under the laws of the state of California that I observed:

  1. The instruments and needle in a clean and sterile cartridge
  2. The cartridge opened in my presence
  3. The piercer put on clean gloves on more than one occasion
  4. The needle placed in Sharps container
  5. All the materials disposed of after the piercing
  6. All the countertops and tables sanitized after the piercing.

We require a photocopy of your ID. You can take a picture with your phone and attach the image here.

Please take a photo of the Sterilization Integrator Strip from your procedure

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