This form is designed to provide you with the information you need to know before making a decision on whether or not laser hair removal treatments with ALMA SOPRANO ICE PLATINUM is for you at GLAM LAB. If you have any questions or do not understand any part of this consent, please do not hesitate to ask.
I understand the nature of my condition, the nature of the procedure, the alternative treatments available, and the benefits to be expected with alternative approaches. I understand that laser hair removal is not 100% permanent but a reduction of up to 80-90% and that optimal results are achieved only with a series of treatments. I understand that I will see optimal results after one treatment and to be consistent by completing the treatment plan that has been fully explained to me.
Just as they're benefits to the procedure proposed, I understand that this procedure also involves risks. I understand that serious complications are rare but possible. Common side effects include temporary redness and mild "sunburn" like effects that may last a few hours to 3-4 days or longer.
Pigment changes (light or dark spots on the skin) lasting 1-6 months or longer may occur. Other potential risks include itching, pain, bruising, blistering, redness and swelling. There is a rare possibility that a scar at the treatment site may develop. Laser light can cause eye damage and it is necessary to use protective eye wear. Eye wear must be worn at all times during treatment. I understand that the hair removal treatment only targets dark hair, that any grey, red or light hair may not see any reduction in growth.
I confirm that I am not pregnant at this time, and I have not taken Accutane/ Retin A within the last 6 months. I am not taking antibiotics/ photosensitizing medication or have discontinued 2 weeks prior to my laser treatment. I haven't had botox/ filler, or any kind of injections done in the past 2 weeks. I do not have a pacemaker, internal defibrillator, and I haven't been exposed to the sun for a week.
For my future treatments, in case of any changes in my medical condition, medications, or exposure to sun, I will notify my laser specialists before every procedure.
I consent to photographs being taken to evalulate treatment effectiveness, for medical education and training. No photographs revealing my identity will be used without my consent.
"Before and After Instructions" have been discussed with me. The procedure, as well as potential benefits and risks, have all been explained to my satisfaction. I have had all my questions answered. I freely consent to the proposed treatment. I certify that I am a competent adult of at least 18 years of age or that if I am a minor under the age of 18, I understand that the consent of my parent/legal guardian that has legal custody will also be required before treatment.
I do understand our lateness, cancellation, and rescheduling policy as follows:
Delayed arrival will limit the time of your experience, it can also reduce the effectiveness of your treatment so we ask for you to arrive at least 10 minutes before your scheduled appointment. We are by appointment only, so kindly give us a 24 hours advanced notice from your scheduled appointment time to cancel or reschedule. Failure to provide such notice there will be a $50 fee for standard services or a $100 fee for full body services. This will be charged upon your visit and if you do not agree to pay the fee your appointment will be rescheduled in six weeks from the date of your cancellation. This will indicate of losing a session.