NOTE: Please use our CHECK-UP form if you already have the piercing.

We may request additional photos or ask you to conduct an in-person consultation if we are unable to determine viability from the photos you have supplied.

Your Details

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Phone

Your Age(Required)

Under 16Under 1818-2122-2526-3030+

Piercing Area

Location(Required)

Navel

Daith

Ear Lobe

Flat

Nipple Breast (18+)

Nipple Chest (18+)

Bridge

Eyebrow

Rook

Smiley

Tongue Web

Tongue

Lip (Upper)

Lip (Lower)

Lip (Surface)

Industrial

Dermal Anchor

Surface bar

Penile (18+)

Vulva (18+)

Other

Note: Poor photo quality or focus may delay our response time. We recommend asking a friend for assistance when taking photos.

History

Have you had it done before?(Required)

No, never attempted

Previously pierced, now removed

Previous attempted, but didn’t last

Currently pierced, would like it redone

How long ago was it pierced?(Required)

The last monthThe last 6 monthsThe last yearMultiple years ago

When was it taken out?(Required)

The last monthThe last 6 monthsThe last yearMultiple years ago

Lifestyle

How long ago was your last piercing?(Required)

The last 3 months

The last 6 months

The last year

Longer than a year

I have not had a piercing before

What piercings have you had in the past 12 months?(Required)

Sleeping(Required)

Only on my stomachOnly on my backOnly on my sideMostly on my stomachMostly on my backMostly on my sideNot sure! (I'm sleeping)

Sports and physical activites(Required)

No sports activitiesSome sports activitiesNo sports for 6+ monthsNo sports for 12+ months

Can you have the piercing?(Required)

Yes

Yes, but I need to hide it

No, I have to remove it

Not sure

Do you swim?(Required)

No

Yes, occasionally in chlorine/public pools

Yes, often in chlorine/public pools

Yes, occasionally in the beach/salt water pools

Yes, often in the beach/salt water pools

Do you often wear headphones/earbuds?(Required)

Yes, over-the-ear headphones

Yes, ear buds

Sometimes, over-the-ear headphones

Sometimes, ear buds

No, or I don’t need to

Navel Consultation

Standing (straight on)(Required)

Drop files here or Select files

Max. file size: 64 MB, Max. files: 5.

Standing (from the side)(Required)

Sitting (allow some slouch)(Required)

Laying Down (From above)(Required)

Ear Consultation

Front on photo (no touching!)(Required)

Side on photo (no touching!)(Required)

Behind photo (no touching!)

Daith Consultation

Front On (Entire ear)(Required)

Side On (Focus on ear canal)(Required)

Nipple Breast Consultation

Front On (Bra freshly off)(Required)

Close Up (Front on)(Required)

Close Up (Side on)(Required)

Nipple Chest Consultation

Front On(Required)

Close Up (Front on)(Required)

Close Up (Side on)(Required)

Bridge

Front on (Relaxed Face)(Required)

Side on (Relaxed Face)(Required)

Top down (Relaxed Face)(Required)

Eyebrows High(Required)

Eyebrows Low(Required)

Eyebrow Consultation

Relaxed Face(Required)

Eyebrows High(Required)

Eyebrows Low(Required)

Smiley Consultation

Upper lip lift up (Front on)(Required)

Upper lip lift up (Side on)(Required)

Tongue Consultation

Mouth open, tongue relaxed(Required)

Tongue up, inside mouth(Required)

Tongue up, outside mouth(Required)

Lip (Lower) Consultation

Lip outside (mouth relaxed)(Required)

Lip outside (Smile)(Required)

Lip (Upper) Consultation

Lip outside (mouth relaxed)(Required)

Lip outside (Smile)(Required)

Lip inside(Required)

Lip (Surface) Consultation

Lip outside (mouth relaxed)(Required)

Lip outside (Smile)(Required)

Lip outside (Kissy Face)(Required)

Surface Consultation

Location on your body(Required)

Please use a pen or similar to mark where you are thinking.

Close up photo(Required)

Intimate Consultation

NO ERECTIONS PLEASE

Any inappropriate photos of sexual activity will result in your submission being deleted immediately and a ban placed on booking any further appointments.

Specific Location(Required)

Prince Albert (PA)

Frenum

Ampallang and Apadravya

Reverse Prince Albert (RPA)

Scrotal

Guiche

Foreskin

Dermal Anchor

Other Penile Piercing

Specific Location(Required)

Vertical Clitoral Hood (VCH)

Horizontal Clitoral Hood (HCH)

Triangle

Christina

Labia Minora (Single)

Labia Minora (Pair)

Labia Majora (Single)

Labia Majora (Pair)

Dermal Anchor

Other Vulva Piercing

Other Intimate Piercing Area(Required)

Front on(Required)

Side on(Required)

Other Consultation

Specific Location(Required)

Specific Location(Required)

Front on(Required)

Side on(Required)

Other Information

Anything else we should know?