Jewelry Cleaning

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Practioner *

Trinity
Modey
Other

Type of Appointment *

Scheduled
Walk-in

Type of Cleaning *

Without removal of jewelry
Ultrasonic
Over night

Number of pieces to be cleaned *

Please list any sensitive gemstones *

Additional Information

Please upload a photo of each area to be cleaned before removal *

Drag & Drop Files, Choose Files to Upload You can upload up to 4 files.

WAIVER, RELEASE, AND CONSENT TO JEWELRY CLEANING

PLEASE READ AND BE CERTAIN THAT YOU UNDERSTAND AND AGREE TO THE IMPLICATIONS OF SIGNING THIS DOCUMENT.
PLEASE READ CAREFULLY AND THEN INITIAL NEXT TO EACH PROVISION TO SHOW THAT YOU UNDERSTAND AND AGREE TO WHAT IS WRITTEN.

Please initial in all of the spaces provided

By initialling you show that you have read and understand all of the provisions below

I understand that cleaning is performed only on jewelry purchased through AVA Piercing Company. *

Please initial above

I understand that some gemstones cannot safely be placed in an ultrasonic cleaner, and the level of cleaning performed may vary depending on the gemstones in my jewelry. *

Please initial above

I understand that while AVA Piercing Company will take the utmost care to avoid damaging my jewelry during the cleaning process, it is not possible to fully guarantee that no damage will occur. In the event that jewelry is damaged, I am responsible for purchasing a replacement piece while a repair or special order is arranged, or I may choose to leave the jewelry out of my piercing at my own risk of the piercing closing. *

Please initial above

Jewelry worn in healing or healed piercings may contain bacteria or other contaminants. While our staff follows strict cross-contamination protocols, jewelry cleaning does not sterilize jewelry for re-use in new piercings. There is always a small risk of cross-contamination when cleaning previously worn jewelry. *

Please initial above

Removing and reinserting jewelry may cause irritation, prolonged healing, or closure of the piercing. I understand that if I fail to return for reinstallation after a deep clean, my piercing may shrink or close. After reinserting jewelry, I may also experience swelling, redness, or irritation. *

Please initial above

Jewelry cleaning is not a medical procedure. Staff are not medical professionals and cannot diagnose or treat infections or other health conditions. *

Please initial above

I accept responsibility for returning on time to have jewelry reinstalled after a deep cleaning. *

Please initial above

Jewelry left at AVA Piercing Company for cleaning or repair must be picked up promptly once I am notified it is ready. If jewelry is not retrieved within 90 days, and after at least two documented attempts to contact me, it will be considered abandoned. AVA Piercing Company cannot resell used jewelry or store jewelry indefinitely and may dispose of abandoned items at its discretion. AVA Piercing Company is not responsible for replacement. Shipping of unclaimed jewelry may be arranged only at the client’s expense. *

Please initial above

I understand that for health and safety reasons, all sales are final. Jewelry cannot be returned or exchanged under any circumstances. *

Please initial above

I release all rights to any photographs taken of me and the piercing and give consent in advance to their reproduction in print or electronic form.

Please initial above. If you prefer not to have photos of your piercings taken, please leave this blank.

I understand that all jewelry used at Ava Piercing Company is covered by a manufacturer’s warranty only and that the warranty does not extend to jewelry that I have lost or damaged due to my own negligence. Ava Piercing Company and its piercers and employees are not responsible for replacing jewelry that I have lost or damaged and I must purchase any jewelry that needs replaced after I have lost it. *

Please initial above

I understand this consent form is a legal document and that by signing it I acknowledge and accept the risks described. *

Please initial above

I acknowledge that I have had the opportunity to read this consent form, ask questions, and that I understand the information provided to me. *

Please initial above

If there is any provision, section, subsection, clause, or phrase of this release that is found to be unenforceable or invalid, that portion shall be severed from this contract. The remainder of this contract will then be reconstructed as though the unenforceable portion had never been contained in this document.

This consent form must be signed by anyone of legal age or by a parent/legal guardian if under 18. By signing as parent/legal guardian, I confirm that I have legal authority to consent on behalf of the minor.

I HAVE READ THIS AGREEMENT, I UNDERSTAND IT, AND I AGREE TO BE BOUND BY IT.

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Today's Date *

Signature *

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WAIVER, RELEASE, AND CONSENT TO JEWELRY CLEANING

Please initial in all of the spaces provided

This consent form must be signed by anyone of legal age or by a parent/legal guardian if under 18. By signing as parent/legal guardian, I confirm that I have legal authority to consent on behalf of the minor.

I HAVE READ THIS AGREEMENT, I UNDERSTAND IT, AND I AGREE TO BE BOUND BY IT.

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Jewelry Cleaning

Let us handle this part!

WAIVER, RELEASE, AND CONSENT TO JEWELRY CLEANING

Please initial in all of the spaces provided

This consent form must be signed by anyone of legal age or by a parent/legal guardian if under 18. By signing as parent/legal guardian, I confirm that I have legal authority to consent on behalf of the minor.

I HAVE READ THIS AGREEMENT, I UNDERSTAND IT, AND I AGREE TO BE BOUND BY IT.

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