Piercing consent form

    1. Name piercing artist: Bella

    Address Studio
    Swallow Ink Tattoo
    Steenbergsestraat 44
    4611 TG, Bergen op Zoom

    Customer information:

    Date of birth:

    E-mail address customer:

    2. Customer statement:
    I have considered the following information about the risks of getting a piercing:







    Piercing artist statement:

    Signature date:

    Handtekening Piercer:

    Signature costumer: