DOING WHAT WE LOVE SINCE 2002

Piercing application form tongue

APPLICATION PIERCING


APPLICATION MUST BE COMPLETED IN FULL
and hereby acknowledge that I have been given full opportunity to ask any all questions which I might have about obtaining a tattoo from "INDUSTRIAL ART" and that all my questions have been answered to my full and total satisfaction

MEDICAL HEALTH HISTORY

(Please read first, then initial before each sentence)

I do not have diabetes.
I am not pregnant or nursing.
I do not have epilepsy or hemophilia
I do not have any allergies to metal, latex, soap, and/or medications
I do not suffer from any heart conditions or take any medication that thins my blood
I am not under the influence of alcohol or drugs
I do not have any physical, metal or medical impairment or disability, which might affect in a direct or indirect way my decision to have a tattoo done at this time

CONSENT, RELEASE AND WAIVER OF ALL CLAIMS

(Please read first, then initial after each sentence)

I specifically acknowledge the following:

Obtaining this tattoo is my choice alone and will result in a permanent change to my appearance, and that "NO" representation has been made to me as to the ability to later restore the skin involved in this tattoo to it is pre-tattoo condition.
It is not reasonably possible for the tattoo artist determine whether I might have an allergic reaction to the tattoo or processes involved in it and further acknowledge that such reaction is possible
Infection is always possible as a result of obtaining a tattoo
I realize that i have the alternative not to get this tattoo and therefore, I give consent to my tattoo artist named in section 1 to tattoo my
I understand this tattoo usually takes 2 weeks or longer to heal. I agree to release and forever discharge and hold harmless the tattoo artist, all employees and owners from any and all claims, damages or legal actions arising from or connected in any way with my tattoo or procedure and conduct used in the same

RECOMMENDED CARE OF NEW PIERCING

Tongue, Cheek & Lip: (Estimated healing time: 4 to 6 weeks).

These piercings require special care. Gently suck on ice for the first 24 to 48 hours after your piercing to minimize swelling. Rinse with LISTERINE antibacterial mouthwash for 30 to 60 seconds after consuming anything other than water. (If Listerine is too harsh, you might want to dilute it with water for the first few days).
Twice a day use GLY-OXIDE following the instructions on the bottle. DO NOT omit this step, you might want to rinse with water after using.
Reduce your intake of warm beverages, hot/spicy foods or anything that might irritate your mouth during healing, especially for the first week.
Extreme pain and large amount of pus discharge are some signs and symptoms of infection, if those occur, please consult with a physician.

WHAT TO AVOID WHILE A PIERCING IS HEALING

Avoid Smoking while your piercing is healing.
Avoid aspirin, excessive amounts of caffeine, and Alcoholic beverages.
Avoid playing with the piercing for the initial healing time.
Avoid chewing on tobacco, gum, fingernails, pencils etc.
Avoid oral sexual contact including French (wet) kissing or oral sex.

After reading and understanding the above aftercare instructions, I agree to follow all instructions concerning the care of my piercing while it is healing.

**By entering your name in the box below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge**
Upload your Photo ID*