Piercing
Registration & Consent Form


Shop 2178 Level 2, Westfield Parramatta, 159-175 Church Street, Parramatta NSW 2150    Ph: (02) 9635 8582

Shop 147, Westfield Penrith, 585 High Street Penrith NSW 2750    Ph: (02) 4732 3307

Shop Gr 062, Rouse Hill Town Centre, Windsor Rd & White Hart Drive Rouse Hill, NSW 2155    Ph: (02) 8814 1855

Shop 175A, Chermside Westfield Shopping Centre, Gympie Rd, Chermside QLD 4032    Ph: (07) 3359 3160

Shop G121, Grand Plaza Shopping Centre, 27-49 Browns Plains Road, Browns Plains, QLD, 4118    Ph: (07) 3800 0445

Shop 1039, Indooroopilly Shopping Centre, 322 Moggill Road, Indooroopilly, QLD, 4068    Ph: (07) 3378 7270

Shop 132, Strathpine Centre, 295 Gympie Rd, Strathpine, QLD, 4500    Ph: (07) 3205 5422

Shop 130, Armada Arndale, 470 Torrens Road Kilkenny SA 5009    Ph: (08) 8244 5055

Shop GO46, Castle Plaza Shopping Centre, 992 South Road Edwardstown SA 5039    Ph: (08) 8277 0065

Shop 25 Churchill Centre, 400 Churchill Road Kilburn SA 5084    Ph: (08) 8260 1210

Shop SP207, Colonnades Shopping Centre, Beach Road Noarlunga Centre SA 5168    Ph: (08) 8382 8222

Shop 2a, Elizabeth Shopping Centre, 50 Elizabeth Way Elizabeth SA 5112    Ph: (08) 8252 6644

Shop H, Gawler Central Shopping Centre, Cnr Cowan and Murray Street, Gawler SA 5118    Ph: (08) 8523 4000

Shop G026A, Golden Grove Village Shopping Centre Golden Grove SA 5125    Ph: (08) 8251 2277

Shop 58, Hallett Cove Shopping Centre, Cnr. Ramrod Ave and Lonsdale Rd, Hallett Cove SA 5158    Ph: (08) 83813444

Shop 70A, Hollywood Plaza Shopping Centre, Winzor Street, Salisbury Downs SA 5108    Ph: (08) 8258 2222

Shop 1006, Ingle Farm Shopping Centre, Cnr Walkleys and Montague Rd, Ingle Farm SA 5098    Ph: (08) 8395 5100

Shop 1089, Westfield Marion, 297 Diagonal Rd, Oaklands Park SA 5046    Ph: (08) 8296 0711

Shop T87, Munno Para Shopping Centre, 600 Main North Road, Smithfield SA 5114    Ph: (08) 8254 3555

Shop 21, Northpark Shopping Centre, 264 Main North Rd, Prospect SA 5082    Ph: (08) 8269 3337

Shop 27, Norwood Place, 161 The Parade, Norwood SA 5067    Ph: (08) 8333 0400

142 Rundle Mall, Adelaide, SA, 5000    Ph: (08) 8223 6644

Shop 131, Westfield Tea Tree Plaza, 976 North East Rd, Modbury SA 5092    Ph: (08) 8264 1888

Shop 24, Unley Shopping Centre, 204 Unley Rd, Unley SA 5061    Ph: (08) 8272 2844

Shop 17, Westfield West Lakes, 111 West Lakes Blvd, West Lakes SA 5021    Ph: (08) 8355 3577

Shop 254, Chadstone Shopping Centre, 1341 Dandenong Rd, Chadstone, VIC, 3148    Ph: (03) 9563 2700

Shop 718, Chirnside Park Shopping Centre, 239-241 Maroondah Highway, Chirnside Park, VIC, 3116    Ph: (03) 9727 4111

Shop SP066 Cranbourne Park Shopping Centre, 125 S Gippsland Hwy, Cranbourne, VIC, 3977    Ph: (03) 5998 8565

Shop 1143, Eastland Shopping Centre, 175 Maroondah Highway, Ringwood, VIC, 3134.    Ph: (03) 8820 8123

Shop 205, Westfield Doncaster, 619 Doncaster Rd,Doncaster, VIC, 3108.    Ph: (03) 9848 2400

Shop 12, Pacific Epping, Cnr High & Cooper Streets,Epping, VIC, 3076.    Ph: (03) 8401 3249

Shop 2073, Level 2, Westfield Fountain Gate, 352 Princes Highway,Fountain Gate, VIC, 3805.    Ph: (03) 9704 0889

Bayside Shopping Centre, Shop G4 28 Beach St, Frankston, VIC, 3199.    Ph: (03) 9783 1322

Shop 304, Greensborough Plaza, Level 3 25 Main Street, Greensborough, VIC, 3088.    Ph: (03) 9434 0055

Shop 3017, Highpoint Shopping Centre 120 - 200 Rosamond Road,Maribyrnong, VIC, 3032.    Ph: (03) 9317 8887

Shop 3101, Westfield Knox Shopping Centre, 425 Burwood Highway,Wantirna South, VIC, 3152.    Ph: (03) 9800 4511

Shop LG52A, Melbourne Central Shopping Centre, 211 La Trobe Street,Melbourne, VIC, 3000.    Ph: (03) 9654 9919

Shop 23, Bentons Square Shopping Centre, 210 Dunns Rd,Mornington, VIC, 3931.    Ph: (03) 5973 6300

Shop W003, Northland Shopping Centre, 50 Murray Road,East Preston, VIC, 3072.    Ph: (03) 9471 2066

Shop 1013, Westfield Southland, 1239 Nepean Hwy,Cheltenham, VIC, 3192.    Ph: (03) 9584 8454

Shop T2.73 (opp. Best & Less), Armadale Shopping City, 206 Jull Street, Armadale WA 6112    Ph: (08) 9399 8099

Shop 23 Bunbury Forum Shopping Centre, Sandridge Road, Bunbury WA 6230    Ph: (08) 9721 5848

Shop 1083B, Westfield Carousel, 1382 Albany Highway, Cannington WA 6107    Ph: (08) 9356 3788

Shop 222, Claremont Quarter Shopping Centre, 9 Bay View Terrace, Claremont, WA, 6010    Ph: (08) 9383 1954

Shop 320 (near Target), Cockburn Gateway Shopping City, 816 Beeliar Drive, Success WA 6164    Ph: (08) 9499 4555

Shop T38, The Shops At Ellenbrook, 11 Main Street, Ellenbrook WA 6069    Ph: (08) 6296 5638

Shop 1085, Galleria Shopping Centre, Cnr Collier & Walter Roads, Morley WA 6062    Ph: (08) 9375 8666

Shop 5, Stirlings Central Shopping Centre, 54 Sanford St, Geraldton WA 6530    Ph: (08) 9965 4250

Shop 017, Halls Head, Central 14, Guava Way Halls Head WA 6210    Ph: (08) 9535 6834

Shop 1084, Westfield Innaloo, Ellen Stirling Boulevard, Innaloo WA 6018    Ph: (08) 9244 4407

Shop T71, Lakeside Joondalup Shopping City, 420 Joondalup Drive, Joondalup WA 6027    Ph: (08) 9300 0410

Shop 13, Livingston Marketplace, Cnr Ranford & Nicholson Roads, Canning Vale WA 6155    Ph: (08) 6253 8055

Shop 2, The Village at Margs, 49 Town View Terrace Margaret River WA 6285    Ph: (08) 9758 7473

Shop SP061 Mandurah Forum Shopping Centre, 330 Pinjarra Road Mandurah WA 6210    Ph: (08) 9582 8531

Shop G083A, The Square Mirrabooka, 43 Yirrigan Drive Mirrabooka WA 6061    Ph: (08) 9344 1044

Shop T174, Ocean Keys Shopping Centre (near Coles), 36 Ocean Keys Blvd, Clarkson WA 6030    Ph: (08) 9407 9590

Shop M10, Carillon City Shopping Centre (near Miss Maud), 207 Murray Street Perth WA 6000    Ph: (08) 9322 5401

Shop G36B, Rockingham Shopping Centre, 1 Council Avenue, Rockingham WA 6168    Ph: (08) 95912233

Shop 69A, Southlands Boulevarde, 45 Burrendah Boulevard, Willetton WA 6155    Ph: (08) 9332 6388

Shop SP045, Warwick Grove (near Coles), Cnr Beach & Erindale Roads, Warwick WA 6024    Ph: (08) 9243 8200

Shop 156, Westfield Whitford City, Cnr Marmion & Whitfords Ave Hillarys WA 6025    Ph: (08) 9307 4288


Piercing Client's Health Check

Please answer the following questions with a Yes or a No.
Where you have answered Yes, please provide further details.

(That’s ok! Choose Titanium or Bioplast for your piercing)

(Please consult your doctor for advice before piercing)

(Please consult your doctor for advice before piercing)

(Please consult your doctor for advice before piercing)

(You may be more prone to fainting. Please consult your doctor for advice before piercing)

(You may be prone to fainting)

(When you take your piercing out, you may get a scar)

(e.g. Acne medications including roaccutane, anti-biotics, blood thinners, etc)
(Both client and therapist are required to wear masks for all salon services.)

Client Information

(Information entered in this section must be for the person receiving the piercing).

Enter your full date of birth including year.
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Upload a picture of your photo ID (e.g. Drivers License, Passport).
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Upload a picture of your photo ID (e.g. Drivers License, Passport).

You must be 18 or over to have a nipple piercing, genital piercing or dermal piercing.

You must be 18 or over to have a nipple piercing, genital piercing or dermal piercing.


Parent/Guardian Consent

Piercing/Guardian Consent

Piercing/Guardian Consent

IF CLIENT IS UNDER 16:

A parent/legal guardian must provide ID and permission for body piercings. The parent identified below must attend the appointment with their ID.

IF CLIENT IS UNDER 16 (or for body piercings in Western Australia, under 18):

A parent/legal guardian must provide ID and permission for body piercings. The parent identified below must attend the appointment with their ID.

IF CLIENT IS UNDER 16 (or for body piercings in Western Australia, under 18):

A parent/legal guardian must provide ID and permission for body piercings. The parent identified below must attend the appointment with their ID.

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Upload a picture of your photo ID (e.g. Drivers License, Passport).
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Upload a photo of your Medicare Card showing both the Child's & Parent/Legal Guardian's Names.

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I acknowledge that Essential Beauty have carried out the treatment of skin penetration listed above at my request. In consideration of this, I agree that Essential Beauty will not be responsible for any damage that is caused to my skin by the procedure and I shall not be entitled to take any action against the company either at Common Law or in Equity in respect of the treatment. I understand that in respect of the body piercing listed above, the minimum grade jewellery that will be inserted is 316L grade surgical steel. In some cases, people can be allergy prone to surgical steel and in this case, titanium, bioplast or 14-18 karat gold will be used. In a small amount of cases, the body can reject a body piercing altogether regardless of the material inserted. I understand that I am responsible for the maintenance of my piercing, and the home care instructions that have been explained to me must be adhered to in order to promote healing. I acknowledge that I have been given the opportunity to ask any questions that I have felt necessary and that any questions asked have been answered to my satisfaction. I understand that, genital piercing clients (nipples included) must be a strict 18 years or above in QLD, SA, VIC & WA, and 16 years or above in NSW, no exceptions with or without parental consent. This is government legislation.

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Photo identification has been sighted by the therapist performing the procedure, and if the client is under 16, parent/legal guardian has been spoken with and permission for the body piercing has been given.