Piercing Troubleshooting Form

There are many reasons that piercings can flare up, even those that have been healed and trouble-free!

Please complete all questions below. Once completed, you will be redirected to our payment page. This small fee of £10 allows for a personal and in-depth analysis. By providing full information, Emma will be able to troubleshoot your issues and determine the likely cause of the problem. Clear high-resolution photos will also help diagnose the issue without an in-person consultation. The response will be via email. If you are able to travel to the Isha Studio in Dorset, we recommend booking in for an in-person consultation. More information on this can be found on our Body Piercing Prices & Booking page,

Please note: all fields marked with a * are mandatory. Thanks!

Piercing Name

Please list piercing name (if not listed)

The History of Your Piercing

When did you acquire this piercing?*

Were you pierced by a professional piercer?*

What method was used for piercing?*

Please select the jewellery Brand you were pierced with *

Brand Name*

Are you still wearing this initial implant jewellery?*

What piercing aftercare are you using? (You can select more than one).

Nothing - my piercing was healed and happy

NeilMed Sterile Saline Spray

Tea tree oil

Home made saltwater solution

Hydrogen peroxide

Other (please list below)

Symptoms

What are the issues with your piercing?*

When did this start?

What material is your jewellery made from? *

Personal Health & Medication

Do you have any health conditions/ailments/allergies? Please list below:

Do you take any prescribed medication? Please list below:

Are you currently suffering from symptoms of stress or anxiety?

Lifestyle

What do you do for a living?

Do you regularly wear the following over or near your piercing?

Do you partake in active sports or fitness? If so, please list type and frequency below:

Has there been trauma to your piercing lately? Has it been caught or pulled?

Do you sleep on the piercing?

Have you removed or changed the jewellery recently?

Please list any beauty products that may be applied near the piercing. These can include make-up, tanning solutions, hairspray, hair dye/bleach, perfume, moisturiser etc.

Please provide any additional information, that may be relevant to your issues or lifestyle:

Photo(s)

Please upload one or two clear, high-resolution photos of your piercing. You may need to ask for assistance! For best clarity, take the photo in natural daylight/near a window.

Please upload a photo showing the front of the jewellery *

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No file selected

Please upload a photo showing the back of the jewellery.

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No file selected

Personal Details

Name*

Email address*

Thanks for completing this form. All details submitted will be kept according to our Privacy Policy,

We will be in touch soon!

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