Full Name *

Date of Birth *

Phone Number *

Email Address *

Address *

Type of Piercing

Location of Piercing

Jewelry Type / Material

Date

Please check any that apply:

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I understand the procedure involves piercing the skin and carries risks including infection, swelling, bleeding, allergic reactions, and scarring
I have had the opportunity to ask questions and all questions have been answered
I am not under the influence of drugs or alcohol
I agree to follow all aftercare instructions provided
I understand failure to follow aftercare instructions may result in complications
I understand that no guarantees have been made regarding healing or outcome

I voluntarily assume all risks and release Zaana Jewelry, its employees, and affiliates from any liability, claims, or damages arising from this procedure

Client Signature

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Date

Madelyn Daniels

Please read the following aftercare instructions carefully. Proper aftercare is essential for safe healing.

Clean piercing 2–3 times daily with sterile saline solution (0.9% sodium chloride)•
Gently pat dry with clean, disposable paper products — avoid cloth towels•
Do NOT use alcohol, hydrogen peroxide, Bactine, or harsh soaps on your piercing•
Wash hands thoroughly before touching or cleaning your piercing

Do NOT remove or change your jewelry during the healing period•
Initial jewelry is selected for proper healing — downsizing may be needed after swelling subsides•
Visit Zaana Jewelry for any jewelry changes or if you have concerns•
Only use implant-grade materials: titanium, 14k/18k gold, or niobium

If you have questions about your piercing aftercare, contact Zaana Jewelry.

FRANCE Collection