Ear Piercing Exception
Many states do not require parental consent for minors to have their earlobes pierced, but will require it for body piercing. Piercers should stay up to date on local laws for ear piercings.
State Specific Forms
Some states provide their own recommended consent forms for the piercing of a child.
Florida Piercing Consent Form – Florida parents can use this form provided by the Department of Health to give permission for piercing their children.
Download: PDF
New York Piercing Consent (Form 5072) – A form provided by the NYDOH for consent to pierce a minor.
Download: PDF
Texas Body Piercing Parental Consent Affidavit – A piercing consent form provided by the Texas Department of State Health Service.
Download: PDF
Sample
Download: PDF, MS Word, OpenDocument
MINOR (CHILD) PIERCING CONSENT FORM
State of [STATE]
County of [COUNTY]
[NAME OF PARENT OR LEGAL GUARDIAN]
Parent/Legal Guardian Name
Residing at: [ADDRESS]
HEREBY SWEARS OR AFFIRMS UNDER PENALTY OF PERJURY, that the
following facts as stated in this document are true:
- I am the natural parent or legal guardian of: [NAME OF MINOR CHILD]
- My child’s date of birth is: [MM/DD/YYYY]
- My child’s age is: [AGE]
- I have the legal authority to give consent to the body piercing of this child.
- I consent to the body piercing of my child as follows: [LOCATION OF PIERCING ON MINOR CHILD].
Parent / Legal Guardian Signature: ____________________________ Date: [MM/DD/YYYY]
Print Name: [PARENT/GUARDIAN PRINTED NAME]