Laser Consent Form

Click here to download patient forms for laser hair removal consent.

Laser consent form.

Eye damage if baby or parent looks directly into the laser beam. Do not sign this form without reading and understanding its contents. Fraxel treatment consent initial that you have read and understand this page. Yag laser capsulotomy consent form patient name.

The nature of the fraxel restore dual procedure has been explained to me. It will also provide legally protective signatures needed for the establishment providing the procedure. My procedure i hereby give my consent for dr to perform a yag capsulotomy of the left right eye upon me. Fraxel dual is a non ablative fractionated laser.

Parent consent i acknowledge that the doctor has explained my child s condition and the proposed procedure. Guardian name if applicable. It is important that you read this information carefully and completely. I understand the risks of the procedure including the risks that are specific to my child and the likely outcomes.

If you have any questions please do not hesitate to ask some of the possible complications of nd yag laser treatment are. This is an informed consent document which has been prepared to help inform you about laser treatment procedures of skin risks and alternative treatments. This has been recommended to. I do hereby waive release absolve.

I understand the procedure is to be performed at the polyclinic. 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. Gene greenlees md or wendy greenlees rn np has explained the nature and purpose of the laser treatment including any risks and possible complications and has discussed the contents of this form with me. This form is designed to give you the information you need to make an informed choice of whether or not to undergo nd yag laser treatment.

Patient name date. I have read and understand this consent form i agree to its terms and authorize treatment. Complete eye protection is available for all.