I acknowledge by signing this agreement that I have been given the full opportunity to ask any and all questions which I might have about the obtaining a piercing and that all of my questions have been answered to my full satisfaction. I specifically acknowledge I have been advised of the facts and matters set forth below and I agree as follows:

 

•  I am not pregnant or nursing.  If I have any condition that might affect the healing of this piercing, I will inform my piercer.
   

• I do not suffer from medical or skin conditions such as, but not limited to: keloid or hypertrophic scarring, psoriasis at the site of the piercing or any open wounds or lesions at the site of the piercing.
   

• I have advised the Piercer of any allergies to metals, latex gloves, soaps and medications.   I acknowledge it is not reasonably possible for the Piercer to determine whether I might have an allergic reaction to the piercing or processes involved in the piercing and further acknowledge that such a reaction is possible.
   

•  I have truthfully represented to the Piercer I am of age.  I am not under the influence of drugs or alcohol.   To my knowledge, I do not have any physical, mental or medical impairment or disability which might affect my well-being as a direct or indirect result of my decision to have a piercing done at this time. 
   

• I acknowledge that obtaining this piercing 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 piercing to its pre-piercing condition.
   

• I acknowledge infection is always possible as a result of obtaining a piercing.  I have received aftercare instructions and I agree to follow all of them while my piercing is healing.
   

• I agree to be added to The Viper Pit Tattoo Studio Mail list