I hereby authorize my practitioner or any delegated associates, to perform laser hair removal on me. I understand that this procedure works on the growing hairs and not on dormant hairs. For this reason, complete destruction of all hair follicles from any one treatment is unlikely, and I understand that I will require several treatments to obtain a significant, long-term reduction of hair growth. I also understand some people may not experience complete hair loss even with multiple treatments and that it is only effective on hair with color and does not treat white, grey, blonde or red hair.  I understand that genetics, hormones and hair color may interfere with hair loss and I may not respond at all.I am aware of the following possible experiences/risks:

DISCOMFORT ? Some discomfort may be experienced during treatment.
REDNESS/SWELLING/BRUISING ? Short term redness or swelling of the treated area is common and may occur.  There also may be some bruising.
PIGMENT CHANGES (Skin Color) ? During the healing process, there is a possibility that the treated area can become either lighter (hypopigmentation) or darker (hyperpigmentation) in color compared to the surrounding skin.  This is usually temporary, but, on a rare occasion, it may be permanent.
WOUNDS ? Treatment can result in burning or blistering of the treated areas. If any of these occur, please call our office.

INFECTION ? Infection is a possibility whenever the skin surface is disrupted, although proper wound care should prevent this. If signs of infection develop, such as pain, heat, or surrounding redness, please call our office.
SCARRING ? Scarring is a rare occurrence, but it is a possibility if the skin surface is disrupted.  To minimize the chances of scarring, it is IMPORTANT that you follow all post treatment instructions carefully.

EYE EXPOSURE ? Protective eyewear or shields will be provided.  It is important to keep these shields on at all times during the treatment in order to protect your eyes from injury. 
The following points have been discussed with me:

Potential benefits of the proposed procedure
Possible alternative procedures such as electrolysis, waxing, tweezing and depilatories.
Probability of success
Reasonably anticipated consequences if the procedure is not performed
Most likely possible complications/risks involved with the proposed procedure and subsequent healing period
Post-treatment instructions 
For women of childbearing age: By signing below I indicate that I am not pregnant. Futhermore, I agree to keep my practitioner informed should I become pregnant during the course of treatment.Photographic documentation will be taken. I hereby authorize the use of my photographs for teaching purposes. BY SIGNING BELOW, I ACKNOWLEDGE AND CERTIFY THAT I,  Client Name  HAVE READ AND UNDERSTAND THE "CONSENT, RELEASE AND INDEMNITY AGREEMENT" FOR THIS PROCEDURE, AND THAT I AM SIGNING IT VOLUNTARILY.