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Piercing Request Form -Form Fill
Section One
Q1
Name
First Name
Q2
Name
Last Name
Q3
Age
Q4
Email
Q5
Phone Number
Q6
Select Piercing
Quantity
Quantity
Quantity
Q7
Notes & questions you want to add
Q8
I agree with the following statements:
I will wear a mask when entering the building. I will provide photo ID.
I understand failure to arrive on time, failure to bring a valid ID or failure to reschedule within 24 hours will result in forfeiture of deposit.
I will show proof of COVID vaccination with physical card and my vaccination will be at least 15 days prior to my appointment.
Q9
Signature
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