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Get West Suburban Women's Health Consent for Laser Hair Removal

Any questions I have regarding this treatment have been answered to my satisfaction and I fully understand the contents of this consent form. I understand that there are no guarantees that this procedure will effectively remove or reduce hair. I understand that payments for the above procedure are nonrefundable. I hereby authorize and direct West Suburban Women s Health at Antares and members of its staff to perform laser hair removal on me. Consent for Laser Hair Removal I understand that the purpose of this procedure is to remove unwanted hair. The laser is generally not as effective on white gray blonde and red hair. The Light Sheer Laser is FDA approved and allows us to safely and effectively treat patients who are candidates for laser hair removal* discoloration or hypo-pigmentation skin lightening may occur in treated skin also bruising scarring blistering and scabbing. Skin color changes such as hyperpigmentation brown may take several months to resolve if at all* I agree to inform my provider of all medications I am currently taking or will take in the future. I understand that even over-the-counter products and herbal medications can cause adverse reactions. I understand that not informing my provider of any changes increases my chances of developing burns hives and prolonged redness. I also understand that certain medications hormones can cause an increase in hair growth. Sun exposure will increase the likelihood of burning and discoloration and goes against laser protocol* course of these treatments. I understand that sun exposure will increase the chances of in the treated area* Multiple treatments are required due to different hair growth cycles. Individual response will vary according to endocrine system skin type hair color degree of tanning follow up care and the body area being treated* follow post treatment instructions. Acknowledgement The purpose of this treatment has been explained to me and I have had an opportunity to ask questions about the treatments. Any questions I have regarding this treatment have been answered to my satisfaction and I fully understand the contents of this consent form* I understand that there are no guarantees that this procedure will effectively remove or reduce hair. I understand that payments for the above procedure are nonrefundable. I hereby authorize and direct West Suburban Women s Health at Antares and members of its staff to perform laser hair removal on me. Consent for Laser Hair Removal I understand that the purpose of this procedure is to remove unwanted hair. The laser is generally not as effective on white gray blonde and red hair. The Light Sheer Laser is FDA approved and allows us to safely and effectively treat patients who are candidates for laser hair removal* discoloration or hypo-pigmentation skin lightening may occur in treated skin also bruising scarring blistering and scabbing. The laser is generally not as effective on white gray blonde and red hair. The Light Sheer Laser is FDA approved and allows us to safely and effectively treat patients who are candidates for laser hair removal* discoloration or hypo-pigmentation skin lightening may occur in treated skin also bruising scarring blistering and scabbing. Skin color changes such as hyperpigmentation brown may take several months to resolve if at all* I agree to inform my provider of all medications I am currently taking or will take in the future. .

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