Piercing Registration & Consent

Salon Information

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

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

Rouse Hill Town Centre, Shop Gr 062, next door to Coles Windsor Rd & White Hart Dr, Rouse Hill, NSW, 2155    Phone: (02) 8814 1855

Shop U16B, Level 3, Macarthur Square Shopping Centre, 200 Gilchrist Dr, NSW, 2560    Phone: 0406 827 128

Shop G120 Grand Plaza Shopping Centre, Browns Plains, QLD, 4118    Phone: (07) 3800 0445

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

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

Shop 39, Sugarland Plaza Shopping Centre, 115/119 Takalvan Street, Avoca, QLD, 4670    Phone: 0421042275

19 Rundle Mall, Adelaide, SA, 5000    Phone: (08) 8223 6644

Shop Go46, Castle Plaza Shopping Centre, 992 South Road, Edwardstown, SA, 5039    Phone: (08) 8277 0065

Shop 2a, Elizabeth Shopping Centre 50 Elizabeth Way, Elizabeth, SA, 5112    Phone: 08 8252 6644

Shop H Gawler Shopping Centre, Cnr Cowan and Murray Street, Gawler, SA, 5118    Phone: 08 8523 4000

Shop G83, Golden Grove Shopping Centre The Golden and The Grove Way, Golden Grove, SA, 5125    Phone: 08 8251 2277

Shop T58, Hallett Cove Shopping Centre, 6 Ramrod Ave, Hallett Cove, SA, 5096    Phone: (08) 8381 3444

Shop 1006 Ingle Farm Shopping Centre, Cnr Walkleys and Montague Road, Ingle Farm, SA, 5098    Phone: 08 8395 5100

Shop T25B Churchill Centre, 400 Churchill Rd, Kilburn, SA, 5084    Phone: 08 8260 1210

Shop 130, Centro Arndale 470 Torrens Road, Kilkenny, SA, 5009    Phone: 08 8244 5055

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

Shop sp207. Colonnades Shopping Centre Beach Road, Noarlunga Centre, SA, 5168    Phone: 08 8382 8222

Shop 27, Norwood Place Shopping Ctr (opposite Foodland) 161 The Parade, Norwood, SA, 5067    Phone: (08) 8333 0400

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

Shop 70A, Hollywood Plaza Shopping Ctr, Winzor St, Salisbury Downs, SA, 5108    Phone: (08) 8258 2222

Shop T71 Munno Para Shopping Cntr 600 Main North Road, Smithfield, SA, 5114    Phone: 08 8254 3555

Shop 24, Unley Shopping Centre, 204 Unley Road, Unley, SA, 5061    Phone: (08) 7001 6888

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

Shop T06, Port Adelaide Plaza220 Commercial Rd, Port Adelaide, SA, 5015   Phone: (08) 7221 2599

Shop T11 Barossa Central, 1 Murray Street, Nurioopta, SA, 5355   Phone: (08) 8563 0704

Shop 254, Chadstone Shop Ctr, 1341 Dandenong Rd, Chadstone, VIC, 3148    Phone: (03) 9563 2700

Shop 1013, Southland Shopping Centre, 1239 Nepean Hwy, Cheltenham, VIC, 3192    Phone: (03) 9584 8454

620/239-241 Maroondah Hwy, Chirnside Park, VIC, 3116    Phone: 03 9727 4111

Shop SP066 Cranbourne Park High Street, Cranbourne, VIC, 3977    Phone: (03) 5998 8565

Shop 205, Doncaster Shopping Centre, 619 Doncaster Rd, Doncaster, VIC, 3108    Phone: (03) 9848 2400

Shop 12, Epping Plaza, 571-583 High Street, Epping, VIC, 3067    Phone: (03) 8401 3249

Shop 2073, Level 2, Fountain Gate Shopping Centre, 352 Princes Highway, Fountain Gate, VIC, 3805    Phone: (03) 9704 0889

Shop G013 Bayside Shopping Centre, 28 Beach St, Frankston, VIC, 3199    Phone: (03) 9783 1322

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

Shop 005A, Pacific WerribeeCnr Derrimut Rd & Heaths Rd, Hoppers Crossing, VIC, 3030    Phone: 

Shop 2139, Highpoint Shopping Centre, 120 - 200 Rosamond Road, Maribyrnong, VIC, 3032    Phone: (03) 9317 8887

Shop Lg52a, Lower Ground Floor, Melbourne Central Shopping Centre, 211 Latrobe Street, Melbourne CBD, VIC, 3000    Phone: (03) 9654 9919

Shop 23, Bentons Square Shopping Centre, 210 Dunns Road, Mornington, VIC, 3931    Phone: (03) 5973 6300

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

Shop 1143 Eastland Shopping Centre, 171-175 Maroondah Highway, Ringwood, VIC, 3134    Phone: 03 8820 8123

Shop 3101, Knox City Shopping Centre, 425 Burwood Highway, Wantirna South, VIC, 3152    Phone: (03) 9800 4511

Shop T2.38, Armadale Shopping City, 206 Jull Street, Armadale, WA, 6112   Phone: 08 9399 8099

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

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

Shop 1006B, Westfield Carousel, 1382 Albany Highway, Cannington, WA, 6107    Phone: (08) 9356 3788

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

Shop143 Ocean Keys Shopping Centre, 36 Ocean Keys Blvd, Clarkson, WA, 6030    Phone: (08) 9408 5004

Shop G-025, Belmont Forum Shopping Centre, 227 Belmont Avenue, Cloverdale WA, Cloverdale, WA, 6105    Phone: 08 9277 1376

Shop T38, The Shops At Ellenbrook, 11 Main St, Ellenbrook, WA, 6069    Phone: 08 6296 5638

Shop 72, Floreat Forum Shopping Centre, 5 Howtree Place, Floreat, WA, 6000    Phone: (08) 9383 9478

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

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

Shop 1084, Westfield Innaloo, Cnr Ellen Stirling Blvd and Scarborough Beach Rd, Innaloo, WA, 6018    Phone: (08) 9244 4407

Shop T71 , Lakeside Joondalup Shopping City, 420 Joondalup Drive, Joondalup, WA, 6027    Phone: 08 9300 0410

Karrinyup Shopping Centre, SP0293/200 Karrinyup Rd, Karrinyup WA 6018    Phone: (08) 6184 1948

Shop T2B, Mandurah Forum, 330 Pinjarra Road, Mandurah, WA, 6210    Phone: (08) 9534 9677

Shop T47, Midland Gate Shopping Centre 247 Great Eastern Highway, Midland, WA, 6056    Phone: (08) 9250 8999

Shop G03A Mirrabooka Square S/C (near Kmart) 43 Yirrigan Drive, Mirrabooka, WA, 6061    Phone: 08 9344 1044

Shop 1085, Galleria Shopping Centre, 4 Collier Road, Morley, WA, 6062    Phone: (08) 9375 8666

Shop T34/36 Piccadilly Arcade, 700-704 Hay Street, Perth, WA, 6000      Phone: (08) 9322 5401

Shop G36b, Rockingham City Shopping Centre, 1 Council Ave, Rockingham, WA, 6168    Phone: (08) 9591 2233

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

Shop SP 045 Warwick Grove, Cnr Beach & Erindale Roads, Warwick, WA, 6024    Phone: (08) 9243 8200

Shop 69a Southlands Boulevarde Shopping & Entertainment Centre 45 Burrendah Boulevard, Willetton, WA, 6155    Phone: (08) 6117 7716

Piercing Client Health Check

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

(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 prone to fainting. Please consult your doctor for advice before piercing.)
(You may be prone to fainting.)
(You may be prone to developing a keloid scar on the piercing area.)
(e.g. Acne medications including Accutane (isotretinoin), antibiotics, blood thinners, etc)
(We will not pierce clients under the influence of drugs or alcohol.)

Piercing Client Information

(Enter your full date of birth, inlcuding year.)

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

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

You must be 16 or over to have a nipple piercing.

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

Parent/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.

(We will send a copy of your piercing form to the supplied email address.)

(By checking this box you agree that Essential Beauty may send electronic communications to you at the supplied email address. You can unsubscribe at any time.)

Informed Consent

I acknowledge that Essential Beauty will carry 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 may be recommended.  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 a copy of this form will be emailed to the email address I have provided for my records.

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 for nipple piercings and 18 years or above for genital piercings in NSW, no exceptions with or without parental consent. This is government legislation.

Draw signature|Type signatureClear

Salon Use Only

Browse