Free templatePiercing
Piercing consent form
A complete, professional piercing consent and medical history form. Free to download and print - or switch it on inside Lumela and it is created for you, live, in about a minute.
Already built for you
Don't start from a blank form
You do not have to recreate any of this. Choose piercing when you sign up and this exact form appears in your account, ready to send.
What to check before you treat
These are the answers that change whether the appointment goes ahead. The digital version turns the submission red automatically.
- CheckAre you pregnant or breastfeeding?
- StopDo you take blood thinners, or aspirin daily?
- CheckDo you scar badly, or get keloids?
- CheckDo you have diabetes?
- CheckDo you have a condition, or take medication, that affects healing or immunity?
- CheckDo you have hepatitis, HIV or another blood-borne condition?This never changes whether we treat you. It changes how we set up.
- CheckDo you have a heart condition, or a pacemaker?
- CheckDo you have epilepsy or a seizure disorder?
- StopHave you had alcohol or recreational drugs in the last 24 hours?
What the form covers
Template wording is a professional starting point, not legal advice. Have your attorney review it for your state.
Paper works. Until it does not.
A printed form has to be filled in at the appointment, filed somewhere, and found again years later. It cannot flag a contraindication, cannot prove when it was signed, and cannot email the aftercare. The same form, sent as a link, does all three.
Get the piercing form, free
A complete, printable template written for this treatment. No card, no trial, just the form.
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