Consultation pre patch test

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) 1: The 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.

2: There is a risk of temporary hyperpigmentation (brown discoloration) or hypopigmentation (lightening of the skin). In very rare cases this may be permanent. 3: Exposure to the sun either directly before or after the treatment is not recommended. 4: To 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. 5: I 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.

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.

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.