Download the Laser Hair Removal Consent Form that is designed to assist a Laser hair removal procedure. It will address how the procedure works and explains possible risks and side effects. It will also provide legally protective signatures needed for the establishment providing the procedure.
How To Write
Step 1 – Patient should carefully read all of the sections below prior to signing for this procedure. Also, with whomever you are discussing this procedure, ask all of the questions you need to, to be certain that you also are protected
1. Informed Consent –
- The purpose of this Informed Consent is to help you decide whether a laser hair removal cosmetic procedure is right for you and to help you make an informed decision as to whether or not you choose to undergo this procedure. This Informed Consent gives you general information about LHR cosmetic procedures and will explain other treatment options, and identifies the benefits, risks, side effects and possible complications associated with this procedure
2. Laser Hair Removal Procedure –
- This section will discuss exactly what this procedure entails. Read all of it very closely
3. Alternative Procedures –
- Laser hair removals is an elective, a voluntary cosmetic procedure
- This is not necessary or required
4. Not Good Candidates-
- This section addresses those who may not at all be a good candidate for this procedure, such a women who are pregnant or plan to become pregnant
- Those who have too much sun exposure
- Those who have alot of blonde or gray hair as the laser doesn’t always do well on these hair colors etc.
5. Risks and Complications –
- Do take the time to read and understand any risks and/or complications listed in this section. If you are unsure about any of these possible complications, ask the laser hair removal professional who has been working with you
6. Post Procedure Instructions –
- It is very important that you comply with all post procedure instructions. In addition, it is also important that you limit sun exposure after the LHR procedure and use protective sunscreen lotion. You must call your doctor immediately if any complications develop post procedure. Laser-treated areas should not be exposed to sun or tanning beds. By not adhering to the post treatment skin care instructions you may increase the risk of any post procedure complications.
Step 2 – By signing this Informed Consent, you understand and agree as follows in the boxes to be checked
- You must check all of the applicable boxes, basically, stating that you understand any box you check
- Once you have read, understand and agree to all of the information and you have decided to proceed with this procedure the following will be required:
- Patient’s Name
- Patient’s Signature
- Center Representative’s Signature