2 minutes
The Laser hair removal consent form can be filled by anyone who is willing to get the laser hair treatment. The individual must be aware of the risks involved in the treatment.
Patient Full name
Gender
Date of Birth
Phone number
Email address
Address
Emergency Contact number
Do you understand the procedure you are about to undergo?
Do you understand that laser hair removal is a medical procedure?
Have you been given a full explanation of the risks and benefits of laser hair removal?
Do you understand that there is a possibility that you may experience side effects from the procedure?
Do you understand that there is a possibility that the procedure may not be completely effective?
I hereby give my consent for laser hair removal treatment to be performed on me by a licensed technician. I understand that the risks associated with this treatment include, but are not limited to, skin burns, pigmentation changes, and scarring. I understand that these risks will be discussed with me prior to treatment. I also understand that it is my responsibility to inform the technician of any medical conditions that may increase my risk of complications from treatment.
Signature
Date