Physician Acknowledgement Form

Your health and safety are our top priorities.

Gamma Piercing requires your doctor fill out a “Physician Acknowledgement form” if you have any of the following conditions: hemophilia, excessive bleeding, epilepsy, seizures, fainting, narcolepsy, diabetes, or any other health condition that would prevent your body from fighting infection. We also require this form be filled out if you are receiving treatment with anticoagulants, medications that thin the blood, or other treatments with medications that prevent blood clotting. This form must be presented to the staff of Gamma Piercing before you are pierced.

If you do not have any of these conditions, but you have a condition you feel may complicate your healing process, please contact us before you arrive to be pierced.

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