Notification of premises where skin procedures are conducted

Use this form to inform the City of premises where skin penetration procedures are conducted.

Business details

Proprietor details

Proprietor name*

Is the proprietor address different to the business address?*

YesNo

Date of commencement of operation*

Hours of operation*

What type of skin penetration procedures are carried out at the premises*

Acupuncture
Tattooing
Body piercing
Hair removal
Manicure/pedicure
Waxing
Other (please specify below)

If you selected 'other' above, please specify what other procedures will be performed

Please attach a scale copy of premises floor plans showing the position of all fixtures and equipment*

Retype the numbers below:

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