Parental Consent Form
Body piercing is a form of surgery. At the Sydney Medical Body-Piercing Clinic (the Clinic) it is carried out
- by a registered medical practitioner
- using sterile equipment.
We strive to minimise the risk of complications but inevitably problems will occur for some persons. It is unpredictable who will develop complications.
Body-piercing creates breaks in the skin and mucous membranes which can admit viral and bacterial infections. In order to minimise the risk of transmission of disease care should be taken to prevent contact of piercings with other people's bodily fluids.
The risks include, but are not limited to:
- Allergy
- Bacterial infection. This is the commonest complication. Following the written aftercare instructions handed to every patient helps reduce this risk.
- Bleeding
- Hepatitis
- Keloids
- Migration & Rejection of the jewellery
- Nerve damage
- Scarring
- Viral infection
I _______________________ , as parent/guardian give permission for my
daughter/son ______________________________ to have her/his ________________
pierced by the Sydney Medical Body-Piercing Clinic. I acknowledge that
I have read this document and indemnify the Clinic against any damages
arising from this procedure.
Signed: ________________________
Contact Phone Number ____________________
Dated: ___ ___ ______
Revised 3 February 2003
Copyright © 1999-2003 Sydney Medical Body Piercing Clinic