ENTRY TYPE
Date
Time
Appointment
TYPE OF PIERCING
Ear Piercing : details
Body Piercing : details
Facial/Oral Piercing : details
Nose > Extras
EXTRAS
Add Other Services
Other Services > Description
Other Services > Price
Description
ARTIST
Total
Are you 18 or older ?
Age
Name
Surname
Date of birth
ID number
Email
Phone
Address
Parent's Name
Parent's Surname
Parent's Date of birth
Parent's ID number
Parent's Email
Parent's Phone
Parent's Address
Permission
Parent signature
Any heart condition:
Allergies to: anesthetics, adhesive plaster, jewellery or latex?
Are you pregnant or breastfeeding?
Are you taking any blood or medication as Warfarin, Aspirin etc?
Please list any current medications/treatments from the hospital
How did you hear about us?
How did you hear about us? :: other
Customer signature
GDPR Agreement
work_done
send aftercare email
Total
VALUES
11/12/2024
02:19:51 PM
11/12/2024 13:30
FACIAL / ORAL
Nose - £ 30.00
None - £ 0.00
Left nostril
Giuseppe
£ 30.00
Yes
44
Faisa
Saeed
05/10/1978
12345
timiro@live.co.uk
+447947102221
22barbrook house Chatham place Lonond E9 6pe GB
No
No
No
Walking by the studio
I consent to having this website store my submitted information so they can respond to my inquiry.
FALSE
No
£ 30.00