Laser Consent Form

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

Laser consent form.

Guardian name if applicable. This has been recommended to. Fraxel treatment consent initial that you have read and understand this page. 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. I understand the risks of the procedure including the risks that are specific to my child and the likely outcomes. 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. If you have any questions please do not hesitate to ask some of the possible complications of nd yag laser treatment are.

I understand the purpose of this treatment is to treat and possibly correct my diseased tooth and or tissues in my mouth. I understand the procedure is to be performed at the polyclinic. It will also provide legally protective signatures needed for the establishment providing the procedure. It is important that you read this information carefully and completely.

I do hereby waive release absolve. Complete eye protection is available for all. Parent consent i acknowledge that the doctor has explained my child s condition and the proposed procedure. Laser assisted cataract surgery is an addendum to our main cataract consent form ask patients to sign this form if you use the femtosecond laser for some of the steps of cataract surgery or if you use it to perform a relaxing or arcuate incision to treat astigmatism.

I have read and understand this consent form i agree to its terms and authorize treatment. Patient name date. Fraxel dual is a non ablative fractionated laser. The nature of the fraxel restore dual procedure has been explained to me.

Do not sign this form without reading and understanding its contents. This is an informed consent document which has been prepared to help inform you about laser treatment procedures of skin risks and alternative treatments. Yag laser capsulotomy consent form patient name.