hanks for your interest in Metro Laser. Some information prior to your parch test appointment. It does appear in depth but your health & wellbeing is of up most importance to us.For clients with lighter and medium skin tones a patch test is required 24 hours minimum prior to the first treatment. Darker skinned clients with South Asian or African skin types require several weeks to ensure no pigmentation changes occur. In general it is rare for hyper or hypo pigmentation to occur and generally it’s instantly visible – so it’s safe to book your fist appointment for the next day, should you have any adverse results your first appointment will not be considered as cancelled and no charge will be incurred.There is no need to shave prior to a patch testPlease ensure you don’t take Ibuprofen 7 days before any laser therapy treatmentsYour patch test will consist of a few shots in the region you require treatedThe aim is to ensure you don’t have any rare reaction to laser like hyperpigmentation.With Brazilian or Bikini Line we’ll conduct the patch test on the upper bikini line so trousers are more convenient than dresses etcThe patch test takes just 5 minutesIt’s important that you complete your online consultation and print your consent form.You may schedule your first appointment even before you’ve had your patch test – we’ll send you information about how long to book as soon as you make your patch test appointment.If you have a pre-paid voucher from an online website we require the code prior to your appointment – don’t worry you’ll receive an email from us asking for this.Please carefully read the emails we send you about the laser hair removal process so we can answer any questions at your face to face consultation.Our practitioners are male but are particularly sensitive to maintaining your privacy and well used to conducting sessions on more private areas like Brazilian Bikini and nipple hair. We’re not in the least shy but are aware you may feel vulnerable – we do our best to make you feel at ease during the process. You may bring a guest to accompany you however they must also wear Laser Safety Glasses in the consultation room.We look forward to commencing your treatment plan. Prior to commencing it is essential to complete the details below please remember to press submit and receive confirmation we got your form\t\t Patch Test Consultation form Please ensure you see a successful submission when you click the submit button \tStep 1 of 4 \t 25% To answer questions and give you the chance to get the very best results & convenience: there are a few short audio/video presentation clips which watching will really assist. Name* First Last Preferred name to be addressed by if different How should we address you? \t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\tShe/Her Ms \t\t\t\t\t\t\t \t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\tHe/Him Mr \t\t\t\t\t\t\t \t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\tThem/They Mx \t\t\t\t\t\t\t \t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\tPrefer not to say \t\t\t\t\t\t\tDate* DD slash MM slash YYYY Email* Enter Email Confirm Email Phone*Date of Birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Occupation What body/face areas are you coming for laser treatment on?* Where did you find out about Metro Laser Clinic?* Are you an emergency services/NHS employee or member of Glasglowgirls Club * Other than the patch test, Have you already purchased further sessions online?*YesNoHow many sessions did you purchase if yes?Please tell us more if you've had Laser or IPL treatments before enter none if you haven't:* Your Health & Medications Please tell us of any medical conditions you have - if none type 'none'*Please tell us of any medications you are currently taking if none type 'none':*Transitioning Clients only: Hormones for transitioning - please give us more details of any hormone treatments and the duration to date to allow us to best assess the optimal laser energyApplicable Clients: Are you pregnant?*YesNo/Not applicacleHave you had any Covid vaccinations in the past six months - if so how many?*Yes 1Yes 2No/Not applicacleAllergy/Other prevents me getting oneHave you used accutane/roaccutane or similar anti acne?*YesNot in the last yearNeverDo you use oral anti-histamines for allergies?*YesNoDo you get cold sores on your lips?*YesNoDo you take St Johns Wort herbal supplements?*YesNoDo have Lupus?*YesNone of these conditionsSome of theseDo have a light allergy?*YesNone of these conditionsSome of theseDo have a history of cancer, keloid scars tendencies, auto immune conditions?*YesNone of these conditionsSome of theseHave you taken anti acne medication (Accutane) in the last year?*YesNone of these conditionsSome of these Please confirm you have watched our info video* \t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\tYes I watched it \t\t\t\t\t\t\t \t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\tNo I haven't \t\t\t\t\t\t\t \t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\tCan't access it \t\t\t\t\t\t\t Upload photo file for assessmentMax. file size: 128 MB.Should you wish to send us in a photo of hair to assess please upload with a clear image in good light. Out secure servers are encrypted and ultimatley secure. Have you a deep tan from a vacation in the last 4 weeks on the area to be treated or fake tan?*YesNoDo your skin type or facial features more resemble your Mother or Father?* \t\t\t \t\t\t\t \t\t\t\t1 Mother \t\t\t \t\t\t \t\t\t\t \t\t\t\t2 Father \t\t\t \t\t\t \t\t\t\t \t\t\t\t3 Not sure \t\t\t \t\t\t \t\t\t\t \t\t\t\t \t\t\tYour hair colour/type on the area to be lasered:* \t\t\t \t\t\t\t \t\t\t\t1 Powder blonde Blonde,Red, White, Grey \t\t\t \t\t\t \t\t\t\t \t\t\t\t2 Light Blonde or Auburn \t\t\t \t\t\t \t\t\t\t \t\t\t\t3 Light Brown/Mediterranean/Light Asian \t\t\t \t\t\t \t\t\t\t \t\t\t\t4 Dark Brown/Dark Asian \t\t\t \t\t\t \t\t\t\t \t\t\t\t5 Light Black \t\t\t \t\t\t \t\t\t\t \t\t\t\t6 Black \t\t\t \t\t\t \t\t\t\t \t\t\t\t \t\t\tHave you shaved, waxed, plucked, threaded or epilated the hair in the last 3 weeks on the area to be treated?* \t\t\t \t\t\t\t \t\t\t\t1 Shaved \t\t\t \t\t\t \t\t\t\t \t\t\t\t2 Waxed \t\t\t \t\t\t \t\t\t\t \t\t\t\t3 Laser/IPL \t\t\t \t\t\t \t\t\t\t \t\t\t\t4 Epliated with threading, electrolysis \t\t\t \t\t\t \t\t\t\t \t\t\t\t5 Plucked \t\t\t \t\t\t \t\t\t\t \t\t\t\t6 Veet or similar chemical epilation \t\t\t \t\t\t \t\t\t\t \t\t\t\t \t\t\t \t\t\t \t\t\t\t \t\t\t\t \t\t\tYour skin colour/type* \t\t\t \t\t\t\t \t\t\t\t1 Very Pale \t\t\t \t\t\t \t\t\t\t \t\t\t\t2 Pale with beige tint \t\t\t \t\t\t \t\t\t\t \t\t\t\t3 Light Brown/Mediterranean/Light Asian \t\t\t \t\t\t \t\t\t\t \t\t\t\t4 Dark Brown/Dark Asian \t\t\t \t\t\t \t\t\t\t \t\t\t\t5 Light Black \t\t\t \t\t\t \t\t\t\t \t\t\t\t6 Black \t\t\t \t\t\t \t\t\t\t \t\t\t\t \t\t\tWhich ancestral country would you say you've inherited your skin type from?* Certain regions of the world have different reactions this helps us to know if there are specifics relating to you. i.e. Celtic/Nordic skin goes more flush and South Asian skin reacts its it's own unique way. What happens when you stay too long in the sun?* \t\t\t \t\t\t\t \t\t\t\t0 Painful redness, blistering, peeling \t\t\t \t\t\t \t\t\t\t \t\t\t\t1 Blistering followed by peeling \t\t\t \t\t\t \t\t\t\t \t\t\t\t2 Burns sometimes, followed by peeling \t\t\t \t\t\t \t\t\t\t \t\t\t\t3 Rarely burn \t\t\t \t\t\t \t\t\t\t \t\t\t\t4 Never burn \t\t\t \t\t\t \t\t\t\t \t\t\t\t \t\t\tTo what degree do you get browner? \t\t\t \t\t\t\t \t\t\t\t0 Hardly or not at all \t\t\t \t\t\t \t\t\t\t \t\t\t\t1 Light colout tan \t\t\t \t\t\t \t\t\t\t \t\t\t\t2 Reasonable tan \t\t\t \t\t\t \t\t\t\t \t\t\t\t3 Tan easily \t\t\t \t\t\t \t\t\t\t \t\t\t\t4 Turn darker brown quickly \t\t\tPlease tell us if you've had any of these treatments in the last 2 years on the area to be treated : Glycolic Acid (over the counter) Less than 10%\t\t\t Retin-A, Differin Renova, Adapin\t\t\t\t Sunburn \t Moderate peel\t\t\t\t\t\t\t Light peel\t\t\t\t\t\t\t\t Liposuction\t\t\t\t\t\t\t\t Dye laser\t\t\t\t\t\t\t\t Accutane (oral)\t\t\t\t\t\t\t Photoderm (spider veins)\t\t\t\t\t Implant surgery, Deep peel, Laser resurfacing\t, Burns, Surgical scars, Skin graft*Please tell us all facial products that you use if you're having face laser sessions:*enter 'none' if nonePlease tell us if you've had aesthetic treatments like botox, chemical peels, microdermabrasion of fillers on the area to be treated in the last month *enter 'none' if nonePlease tell us if you have any of the following and more about the condition: Diabetes, Keloid scarring, Thyroid condition, Melasma, Vitiligo, Pigmentation disorders, Epilepsy or anxiety disorders *enter 'none' if noneAre you photosensitive, taking St Johns Wort, have Lupus or on any medications which require you to stay out of the sun?* \t\t\t \t\t\t\t \t\t\t\tYes \t\t\t \t\t\t \t\t\t\t \t\t\t\tNo \t\t\t \t\t\t \t\t\t\t \t\t\t\tNot sure \t\t\t \t\t\t \t\t\t\t \t\t\t\t \t\t\t Almost there! Consent Form. Please type I agree where required to indicate you understand and consent to proceed. Consent* I agree to Laser Treatments at Metro and have read the terms.I authorise therapists of Metro Clinic to perform the laser treatment for hair removal using the Polaris Long Pulsed Nd:YAG Laser. I understand that they has been trained at the Polaris training academy under the guidance of a Qualified Laser Operations Trainer and have the standard required by Polaris to operate this equipment or have Advanced required Level 4 certification in Laser & Light . I understand that the laser treatment for unwanted hair with selected laser light at 1064nm has been shown in clinical studies to be a safe and effective alternative to methods used for removing unwanted hair such as shaving, waxing, chemical epilation and electrolysis. I have been specifically advised that: (When you have read and understood each section please initial) \t1: \tThe clinical evaluation of laser epilation is still ongoing but initial studies of patients treated in 1996 show arrest of hair growth in the treated area from time of initial treatment until current date. I have been correspondingly advised that the number of treatments and the length of each treatment can vary from person to person and is dictated by size of area, density of hair, colour of hair and colour of skin. I have been further advised that only hairs in their active growing stage can be successfully treated. For the above reasons I acknowledge that it is not possible to be entirely accurate in determining the number of treatments required to obtain permanent hair loss. Consent* I consent understanding about make up removal where applicable and rare pigmentation issues as described2: \tThere is a risk of temporary hyperpigmentation (brown discoloration) or hypopigmentation (lightening of the skin). In very rare cases this may be permanent. \t3: \tExposure to the sun either directly before or after the treatment is not recommended. \t4: \tTo enable the laser to effectively remove all the growing hairs, it is possible but highly unlikely, that the light intensity may generate slight blistering of the skin that might cause temporary scabbing. These accepted conditions are known and recognised, and will resolve themselves in a relatively short time. No permanent marking is likely, although in rare cases marking may persist. Removal of make up and foundation is essential prior to treatment by clients receiving treatment to facial areas. \t5: \tI acknowledge that I have been advised that on rare occasion’s hair removal by laser might not be successful. I agree to inform the practice if have any changes to medication or develop any medical conditions between appointments. Consent* I agree the conditions as outlined and understand I can ask any questions at the patch test.I have been fully informed of the nature and purpose of the procedure, expected outcome and possible complications. I understand that no guarantee can be given as to the final result obtained. I am fully aware that my condition is of cosmetic concern and that the decision to proceed with treatment is based solely on my expressed wish to do so. Due to operational reasons for laser maintenance Metro Clinic may have to reschedule your appointment. Clients are requested to give 24 hours notice when rescheduling, Metro Clinic will endeavour to re-allocate any cancelled appointments within this time to avoid the cancelled treatment being considered as part of any treatment plan. I have been given the opportunity to ask questions and hereby certify that I have read and fully understand the contents of this consent form before affixing my signature below. Should my medical condition or medications change during my treatments I agree it is my responsibility to inform Metro Laser Clinic. I also agree it is my responsibility to give adequate notice 24/48 hours cancellation as indicated or I will be invoiced for missed appointments at late notice that the clinic is unable to re-allocate. Consent* I agree to the Covid prevention policy.I understand I am required to comply with COVID restrictions and will not attend if I have been required to self isolate when an appointment is scheduled & will inform the clinic if I am currently experience sysmptoms to cancel my appointment & agree my temperature will be taken on arrival.Remember your mask before entry. You can also purchase plans from us cheaper than anywhere else and we appreciate if you refer friends direct to us. You'll find a printed consent form that you need to initial and sign on arrival. You may reschedule appointments on our online booking system following the links at the bottom of the appointment email. The easiest way to contact us is on the clinic mobile by text 07739 479682 if you're delayed etc.