Laser Consent Form

Fraxel treatment consent initial that you have read and understand this page.

Laser consent form. Complete eye protection is available for all. Download the laser hair removal consent form that is designed to assist a laser hair removal procedure it will address how the procedure works and explains possible risks and side effects. Yag laser capsulotomy consent form patient name. It is important that you read this information carefully and completely.

Parent consent i acknowledge that the doctor has explained my child s condition and the proposed procedure. I do hereby waive release absolve. Eye damage if baby or parent looks directly into the laser beam. This form is designed to give you the information you need to make an informed choice of whether or not to undergo nd yag laser treatment.

The nature of the fraxel restore dual procedure has been explained to me. If you have any questions please do not hesitate to ask some of the possible complications of nd yag laser treatment are. I understand the risks of the procedure including the risks that are specific to my child and the likely outcomes. My procedure i hereby give my consent for dr to perform a yag capsulotomy of the left right eye upon me.

Fraxel dual is a non ablative fractionated laser. I have read and understand this consent form i agree to its terms and authorize treatment. This is an informed consent document which has been prepared to help inform you about laser treatment procedures of skin risks and alternative treatments. It will also provide legally protective signatures needed for the establishment providing the procedure.

This has been recommended to. Gene greenlees md or wendy greenlees rn np has explained the nature and purpose of the laser treatment including any risks and possible complications and has discussed the contents of this form with me. Acknowledgement of consent for laser treatment this authorization and informed consent is given of my own free will after the doctor has explained to me the foreseeable dental and medical risks involved and discussed below. Guardian name if applicable.

Do not sign this form without reading and understanding its contents. I understand the purpose of this treatment is to treat and possibly correct my diseased tooth and or tissues in my mouth. Laser assisted cataract surgery is an addendum to our main cataract consent form ask patients to sign this form if you use the femtosecond laser for some of the steps of cataract surgery or if you use it to perform a relaxing or arcuate incision to treat astigmatism.