Laser Hair Removal Consent Form

Laser Hair Removal Consent Form

Patient Information
Preferred Name
Legal Full Name*

First NameLast Name
Parent name (if under 18)

First NameLast Name
Date of birth*

MonthDayYear
Date
Preferred Gender
Gender*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
How did you hear about us?*

Client Treatment Consent And Release
I acknowledge that beauty treatments, the practice of skin care, and the practice of massage, including, but not limited to, microablation, microdermabrasion, waxing, electrolysis, facial toning, permanent cosmetics, body treatments, ionization, laser treatments, tattoo removal, vin treatments, brown spot removal, BOTOX, Collagen, Dermal Fillers, Sclerotherapy, Mesotherapy, Dermaplaning, and various other beauty procedures is not an exact science and no specific guarantees can or have been made concerning the outcome. I understand that some clients experience more change and improvement than others. In virtually all cases, multiple treatments are required in order to realize a difference.

I also understand and agree to assume the following risks and hazards which may occur in connection with any particular treatment including but not limited to: unsatisfactory results, soreness, poor healing, discomfort, redness, blistering, nerve damage, scarring, infection, change in skin pigmentation, allergic reaction, muscle damage, bruising, and increased hair growth. I understand that even tough precautions may be taken in my treatment, not all risks can be known in advance.

Given the above, I understand that response to treatment varies on an individual basis and that specific results are not guaranteed. Therefore, in consideration for any treatment received, I agree to unconditionally defend, hold harmless and release from any and all liability the company and the individual that provided my treatment, the insured, and any additional insureds, as well as any officers, directors, or employees of the above companies for any condition or result., known or unknown, that may arise as a consequence of any treatment that I receive.

I have fully disclosed on my client intake form any medications, previous complications, or current conditions that may affect my treatment. I understand and agree that any legal action of any kind related to any treatment I receive will be limited to binding arbitration using a single arbitrator agreed to by both parties.
Date*

MonthDayYear
Date
Signature*

Clear

Salon Policies
Consent to photograph, record, and video
I agree to give Flavor Beauty Bar LLC consent to take treatment site photos/videos, record my image and/or voice and grant Flavor Beauty Bar LLC all rights to use these recordings or photographs in any medium for educational, promotional, advertising, social media purposes or other purposes. Please Sign Below to agree (no explicit photos will be posted)
We respect your time and we are glad you choose Laser Flavor / Flavor Beauty Bar for your beauty needs. We've created the polices listed below to provide you with versitily and convenience to our guests. When booking a reservation/appointment that is your acceptance of our policies. Make sure that you have reviewed and agreed to the terms listed below.

Please respect our schedule by keeping appointments whenever possible and providing a minimum of 24 hour notice when canceling or rescheduling your appointment. Failure to comply with these guidelines will result in the following policies being enforced. Please note that less than 24 hour notification to cancel, reschedule, or late arrival = late cancelation.

Clients with Packages:

- Loss of treatment

- Non refundable $25 Rebooking Fee if you want the next available

Clients without packages:

- Deposit will be forfieted and not refunded. You will have to schedule again on the website.

- No show/No Show - Full payment will be charged for missed service

- Late Arrival - late arrival may result in your appointment being cancelled or shortened with full charges applied. We will only be able to accommodate you if our schedule allows.

Payment Policies

- We have a no refund policy, however we will consider an exchange for other services at our discretion if treatments aren't strarted and cancelled in advance.

- Vouchers are accepted from NEW CLIENTS ONLY. Vouchers from existing clients will not be redeemed.

By signing at the end of this page you agree to the terms
Date*

MonthDayYear
Date
Signature*

Clear

Treatment Instructions
Treatment Instructions
The purpose of this procedure is to diminish or remove unwanted hair. The procedure requires more than one treatment and may produce permanent hair removal. The total number of treatments will vary between individuals. On occasion there are patients that do not respond to treatments. The treated hair should exfoliate or push out approximately 2-3 weeks. Treatment duration varies from 15-120 minutes depending on the size of the area and the amount of hair.

1. Avoid the sun 2-4 weeks before and after treatment.
2. Hair must be shaved in the treatment area 12-24 hours prior to any hair removal procedure.
3. It is best that you refrain from tweezing, threading, and/or waxing 4 weeks prior to treatment. Shaving is the only method that can be done.
4. You MUST avoid bleaching, plucking or waxing hair for 6 weeks prior to
5. Avoid deep tanning, including tanning beds and tanning creams 2 weeks before and a 1 week after treatment. If you must go in the sun use a sunscreen of SPF 25 or higher.
6. If throughout the course of your treatment, you need to take any photosensitizing medication and/or antibiotics, we will not be able to treat you within 10 days of your last dose.
7. We ask that you arrive to your treatment with no lotions, sprays or creams in the treatment area.
8. A minimum of 6 weeks in between treatments is required to achieve maximum results, depending on the area.
Post Treatment Instructions
1. Immediately after your treatment there may be some redness and bumps ate the treated area which may last about 2 hours or longer. It is normal for the treated area to feel like its been sunburned for a few hours. You can use a cold compress if needed. If you develop any crusting, apply antibiotic cream. It is also recommended that you use aloe vera gel. Darker pigmented people may have more discomfort and may need to use aloe vera or antibiotic longer.*

I Understand
2. Makeup may be used after the treatment, only if you do not have any blistering. It is recommended to used new make up and clean/new application products to reduce the possibility of infection. Use moisturizer under your make up.*

I Understand
3.Avoid sun exposure to reduce the chance of light or dark marks for 2 months. Use sunscreen with a SPF 25 or higher during the course of your treatments and 1-2 months following the treatment.*

I Understand
4. Avoid picking or scratching the treated area.*

I Understand
5. Do not use any other hair removal methods on the treated area during the course of your laser treatments. Using other methods will prevent you from achieving the best results.*

I Understand
6. You can shower after the laser treatments. Make sure you use mild soap and pat dry the treated area. Deodorant can be used after 24 hours.*

I Understand
7. Anywhere from 5-30 days days after treatment shedding of the hair of the hair may start to happen and appear as new hair growth or stubbies. This is not new hair growth it is the dead hair pushing its way out of the follicle. You can exfoliate it by washing/wiping it with a washcloth.*

I Understand
8. Hair growth occurs at different rates on different areas of the body. New hair growth will start to happen at least 3 weeks after treatment.*

I Understand
9. Call us and/or your physicians office with any concerns you may have after treatment.*

I Understand
Date*

MonthDayYear
Date
Signature*

Clear

Laser Hair Removal Consent Form

CLIENT INFORMATION AND MEDICAL HISTORY

Medical History

Salon Policies

Informed Consent

Treatment Instructions

Laser Hair Removal Treatment Questionaire