The Body Piercing Consent Form is a crucial legal document required under Dutch law before performing any body piercing procedure. It serves multiple purposes: documenting informed consent, collecting relevant medical information, and ensuring compliance with Dutch healthcare regulations and GDPR requirements. The form is essential for protecting both the client and the service provider, particularly important given the medical implications of body modification procedures. It includes specific provisions for different age groups (with special requirements for clients aged 12-16), detailed medical history collection, and comprehensive aftercare instructions. This document is mandatory for all body piercing establishments in the Netherlands and must be retained in accordance with local record-keeping requirements.

1. Personal Information: Client's full name, date of birth, address, contact information, and identification details

2. Medical History: Questions about relevant medical conditions, allergies, medications, and other health factors that could affect the piercing procedure

3. Procedure Details: Specific information about the type and location of piercing being performed, including jewelry type and material

4. Risks and Complications: Detailed outline of potential risks, complications, and side effects associated with the piercing

5. Acknowledgment of Information: Client's confirmation that they have received and understood all information about the procedure, risks, and aftercare

6. Consent Declaration: Formal statement of consent to the procedure and acknowledgment of risks

7. Aftercare Instructions: Detailed instructions for caring for the piercing during the healing period

8. Practitioner Declaration: Piercer's confirmation of their qualifications and commitment to following proper procedures