2022 West Northwest Hwy
Suite 120, Grapevine, Tx 76051.



Client Consent form for Laser Hair reduction



I hereby authorize any associates and assistants of Affordable Laser Hair Removal to perform laser hair reduction on me.  These treatments are effective only on actively growing hair, therefore a multiple of treatments will be required to achieve cosmetically acceptable results.  In rare cases, clients may not experience any hair reduction even with series of laser treatments.  I acknowledge that no guarantees have been made regarding the result of the procedure.


Procedure: Laser Hair Reduction
Device Used L Candela Gently YAG-Variable Pulsed ND:YAG (1064nm)-Uses light energy to selectively heat and destroy the hair follicle with minimum harm to the surrounding tissues.


The following points have been discussed with me,  I have been informed and I understand:
(Please initial each statement)


____Eye protection must be worn at all times during the treatment.

____I confirm that I am not pregnant at this time.  It is my responsibility to let my technician know if I    become pregnant during the course of my treatments.

____I am fully aware that my condition is of cosmetic concern and the decision to proceed is based solely on my expressed desire to do so.

____I have been informed that the following possible risks and complications involved with laser hair reduction are Purpura(red-purple discoloration brusing) Erythema and/or Edema (redness and/or swelling), Hypopigmentation or Hyperpigmentation ( lightening or darkening of the skin).

____I am fully aware that exposure to direct sunlight 4 weeks prior and 4 weeks post laser procedure will compromise the treatment.

____Individual sensitivities may be activated such herpes simplex virus.

____Hormone imbalance in females may limit the effectiveness of laser hair reduction.

____Failure to follow the laser schedule may diminish your results and in require more treatments.

____Because the laser treatments will tend to sychromize the growth cycles of the hair, there may be the perception of Increased hair during your treatments.  This usually occurs near the third and fourth treatment.  Do not be alarmed.

____In rare cases Laser hair reduction can stimulate dormant follicles and can actually increases hair growth.

____Anesthesia is usually not necessary as this devise uses a cooling spray to the surface of the skin to reduce Discomfort when the laser pulse is delivered.  Topical anesthetic creams will lessen the discomfort.

____I understand that immediately following the laser treatment redness, swelling, and discomfort may develop at the treatment site, and this should resolve within several hours, but occasionally may last for 2-3 days.

____I have received a copy of the pre and post laser hair reduction.

____I have been notified of the cancellation policy.


Client Signature :  Witness Signature :  Date :
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