Liora Laser Studio LLC

CONSENT FORM

Name

Last Name

Mailing Address

Day of Birth

Día

Mes

Año

MEDICAL HISTORY

3.Do you have a tattoo, micropigmentation or birthmark in the treated area?

Yes

4.Have you been exposed to the sun (natural or artificial) for the last 7 - 14 days?

Yes

5. Do you have any other medical condition or are you taking any medication mentioned above that could affect your treatment?

Yes

If so, please specify:

KNOWLEDGE AND CONSENT

I recognize and understand the following:

1. Description of the treatment: Laser hair removal involves the use of laser light to target and destroy hair follicles in order to prevent future hair growth. This non-invasive procedure aims to eliminate between 80% and 90% of the treated skin.

2. Pre and Post Treatment Care:

Pre-treatment: Avoid direct and excessive exposure to the sun, photosensitizing substances and treatments. In the fleetré, I shaved or waxed the area for a week beforehand and perfected it the day before the session.

Post-treatment: Avoid heat sources, jacuzzis, steam baths, saunas, swimming pools, sports and direct exposure to the sun for 48 hours to 7 days as indicated.

3.Contraindications: I do not have any of the listed contraindications (cancer, heat problems, autoimmune or chronic illness, skin infections, epilepsy, embarrassment, breastfeeding, photosensitizing substances, recent exposure to the sun, tattoos, micropigmentation, birthmarks in the treatment area).

4.Possible Secondary Effects: I understand that I may experience secondary effects such as:

Common Secondary Effects:

Redness and irritations: Temporal, disappear within hours to days.
Swelling: Take it, it will be resolved in hours. Pigmentation changes: Darkening or temporal lightening of the skin.
Stretch formation: This may occur, keeping the area hydrated helps.
Itching: Mild, as a reaction to treatment.

Less Common Secondary Effects:

Skin infection: RISK if the area is not kept clean.
Ampoules and burns: Possible with incorrect laser or inexperienced technicians.
Scars: Rare, generally due to aftercare inadequate.
Changes in the texture of the skin: Rare, may be temporary.
Rare and Serious Secondary Effects:
Severe pain: Some may experience intense pain; anesthetic creams can help.
Allergic reactions: Possible to gel or anesthetic cream.
Eye injury: It is crucial to use eye protection during facial treatment.

5.Treatment Sessions: I understand that multiple sessions (6 to 12) spaced between 4 and 6 weeks are recommended, followed by maintenance as necessary, to obtain optimal results.

6. Eligibility and Contraindications Checks: A diagnostic session is required, which includes a full questionnaire and review of my medical history, to determine my eligibility and any contraindications.