INFORMED CONSENT FOR GENERALIZED LASER TREATMENTS
1. Nature and Purpose of Treatment:
I, the undersigned, hereby authorize B. Sweet aesthetics staff and/or such assistants as may be designated, to perform laser treatment on me.
2. Risks and Potential Complications:
I acknowledge and understand that the laser treatment, like all medical procedures, carries certain risks and potential complications, including but not limited to:
- Erythema (redness), edema (swelling), and localized discomfort.
- Temporary or permanent changes in skin pigmentation, including hyperpigmentation and hypopigmentation.
- Formation of blisters, scabbing, or crusting.
- Risk of scarring or keloid formation, particularly in individuals predisposed to such conditions.
- Risk of infection at the treatment site.
- Possible allergic reactions to post-treatment skincare products.
I understand that while complications are infrequent, they can occur, and the results may vary depending on individual factors.
3. Alternatives to Laser Treatment:
I have been informed of alternative treatments available for my condition, which may include but are not limited to, other laser therapies, chemical peels, topical medications, or no treatment at all. I acknowledge that these alternatives have been explained to me, and I understand the benefits and risks associated with each option.
4. Contraindications and Disclosures:
I have disclosed to the practitioner all pertinent aspects of my medical history, including any history of keloid formation, photosensitivity disorders, or any other conditions that may contraindicate this procedure. I further acknowledge that I am not currently pregnant or breastfeeding, nor am I taking any medications or supplements that may adversely affect the treatment.
5. Pre- and Post-Treatment Instructions:
I have been provided with and understand the pre-treatment instructions, which include but are not limited to avoiding sun exposure and certain medications. I also acknowledge receipt and understanding of post-treatment care instructions, including avoiding sun exposure, applying prescribed ointments, and adhering to follow-up care protocols.
6. Consent to Photographic Documentation:
I consent to the taking of photographs before, during, and after the treatment for the purpose of medical records, education, or marketing, with the understanding that my identity will remain confidential unless otherwise agreed upon.
7. Acknowledgment of Understanding:
I acknowledge that I have had the opportunity to ask questions regarding the nature, purpose, risks, and alternatives to the Pico laser treatment. I confirm that all my questions have been answered to my satisfaction.
8. Voluntary Consent:
By signing below, I hereby give my voluntary consent to undergo laser treatment as proposed. I understand that this consent form does not constitute a guarantee or warranty of the outcome of the treatment.
9. Signature:
I have read and fully understand the contents of this consent form. I am signing this form voluntarily and affirm that I am of sound mind and not under the influence of any substance that could impair my decision-making.
10. Results & expectations
Potential and common side effects that may occur with Picosecond & FOTONA LASER treatments:
• DISCOMFORT may be minimal to moderate. Some areas are more sensitive than others. Topical anesthetic is available for purchase if required. Certain laser treatments include a prescription grade topical anesthetic or can be added on for an additional fee.
• INFLAMMATION which may include irritation, itching, pain, bruising, flaking, ingrown hairs, typically subside/fade in 5-7 days
• ERYTHEMA (redness) and mild to moderate “sunburn” like effects may last for a few hours to 2-5 days
• EDEMA (swelling) of the skin around the treatment site may last 2-5 days, but can be reduced with regular application of a cold gel pack
• PUSTULES or PIMPLES may develop in the first few days following treatment and gradually subside
• TEXTURE CHANGES - Transient texture changes often occur, but usually resolve with time
• BLISTERING, SCABBING or CRUSTING may occur and usually take 4-10 days to heal.
• PETECHIAE may be present after treatment and may last 3 - 5 days.
• FRECKLES/PIGMENT – Existing freckles/pigment in the treated area may temporarily or permanently disappear
• COINCIDENTAL HAIR REMOVAL – There is a possibility of coincidental hair removal when treating pigmented or vascular lesions in hair-bearing areas
SKIN EXPECTATIONS FOTONA
1. Directly after skin will be pink, feel hot & possibly have pinpoint bleeding
2. Day 1-2 moisturize, the skin will be dry and rough to the touch
3. Day 3-5 skin will feel tight and like sandpaper. Dry & wrinkly looking. Don't worry continue to moisturize. At day 5, use a gentle exfoliate to slough excess skin.
4. Results are not immediate - the skin will improve over time. Be patient, best results at 2 to 3 months.