Laughing Buddha Piercing Release Form

Thank you for choosing Laughing Buddha for your piercing 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.

If you are accompanying a minor, please use this form.




Consent

I, the undersigned, being of eighteen (18) years of age or older, hereby consent to a piercing, to be conducted by Laughing Buddha, or any agent or employee of the same as follows:

I acknowledge by submitting this form that I have been given full opportunity to ask any and all questions that I may have and that all my questions have been answered to my full and total satisfaction. To ensure the efficiency of healing, I will inform Laughing Buddha of any conditions, medical or otherwise, which may impair the full and proper healing of my piercing.

Medical Questionnaire

The following medical questions are confidential, and solely used by the staff at Laughing Buddha Body Piercing to ensure the procedure is being performed safely.

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

The undersigned for himself or herself, the heirs, successors, representatives as assigns hereby forever waives releases and discharges Laughing Buddha Body Piercing, their agents, employees, representatives, and other organizations affiliated with this studio and any and all of their heirs, successors or assigns (hereinafter referred to as Releasees.)

The undersigned further agrees to indemnify and do indemnify the Releasees from any and all claims demands, actions, liability and/or damages whatsoever performed under this agreement. The indemnification shall include, but shall not be limited to any and all attorney fees and costs incurred.

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