Body Piercing Client & Health Intake

Edit a body piercing client & health intake template for piercers. Review it online, then unlock licensed PDF, Word, and print tools after purchase.

For Piercers · Intake Form · CA$5

Record client goals, relevant skin, hair, nail, or body history, allergies, sensitivities, medications disclosed by the client, prior services, and the requested authorized body-piercing procedure and jewelry fitting.

Included editable fields

  • Piercer
  • Client / Customer / Authorized Party
  • Client Name / Age
  • Appointment Date / Time
  • Piercing Placement
  • Anatomy / Health Disclosure
  • Jewelry / Material
  • Consent / Aftercare / Photo Choice
  • Intake Date
  • Service / Job Location
  • Job / Service Type
  • Scope / Purpose
  • Client Instructions / Prior History
  • Client Responsibilities
  • Pre-Start Confirmations
  • Known Risks & Disclosures
  • Limitations & Exclusions
  • Information Authorization / Acknowledgement
  • Intake Checklist
  • Follow-Up / Outcome
  • Record Timestamp
  • Service Provider / Professional