• Laser Removal Consent Form - 2022

    Fields marked with an asterisk (*) are mandatory.
  • Date of Birth:*
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  •  -
  • Client's Medical History:

    Do you currently suffer from, or have you ever suffered from any of the following? Tick as appropriate. We may require a doctor’s note if you have selected yes to any.
  • *
  • I declare that the information I have provided on my medical history is correct to the best of my knowledge and that I am not currently under the influence of alcohol or drugs. I hereby give consent for the procedure detailed above to be carried out by the named operator. I can confirm that I have been provided with the written information on (I) the potential complications associated with the procedure and (II) appropriate aftercare advice for the procedure. I agree that it is my responsibility to read this and follow the aftercare advice given until the treatment area is fully healed. I give my consent to the operator to retain the details provided on this form for a period of 2 years from today’s date. I agree to ‘The Studio’ holding onto my details, knowing that it will not be passed onto any third parties and will be used within strict GDPR guidelines.

  • Date*
     / /
     :
  • Laser Technician Section:

    Only to be filled in by the laser technician.
  • Date
     - -
     :
  • Should be Empty: