Laser Consent Form

This has been recommended to.

Laser consent form.

I understand the risks of the procedure including the risks that are specific to my child and the likely outcomes. 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. Do not sign this form without reading and understanding its contents. The nature of the fraxel restore dual procedure has been explained to me.

Fraxel dual is a non ablative fractionated laser. Fraxel treatment consent initial that you have read and understand this page. This is an informed consent document which has been prepared to help inform you about laser treatment procedures of skin risks and alternative treatments. I do hereby waive release absolve.

Guardian name if applicable. It will also provide legally protective signatures needed for the establishment providing the procedure. 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. It is important that you read this information carefully and completely.

Click here to download patient forms for laser hair removal consent. My procedure i hereby give my consent for dr to perform a yag capsulotomy of the left right eye upon me. Patient name date. 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.

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. If you have any questions please do not hesitate to ask some of the possible complications of nd yag laser treatment are. 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. Eye damage if baby or parent looks directly into the laser beam.

Parent consent i acknowledge that the doctor has explained my child s condition and the proposed procedure. Complete eye protection is available for all. I understand the procedure is to be performed at the polyclinic.