Informed Consent for Laser Tattoo Removal

I, consent to and authorize to perform multiple treatments, laser procedures, and related services on me.

The procedure planned uses laser technology for the removal of tattoos. As a patient, you have the right to be informed about your treatment so that you may make the decision whether to proceed for laser tattoo removal or decline after knowing the risks involved.

The following problems may occur with the laser tattoo removal process:

1. The possible risks of the procedure include but are not limited to pain, swelling, redness, bruising, blistering, crusting/scab formation, ingrown hairs, infection, and unforeseen complications which can last up to many months, years, or permanently.
2. There is a risk of scarring. Scarring happens but is uncommon. Scarring can be permanent.
3. Short-term effects may include reddening, mild burning, temporary bruising, or blistering. A brownish/red darkening of the skin (known as hyperpigmentation) or lightening of the skin (known as hypopigmentation) may occur up to 3–6 months, years, or permanently following treatment. Loss of freckles or pigmented lesions can occur.
4. Textural changes in the skin can occur and can be permanent.
5. Infection: Although infection following treatment is unusual, bacterial, fungal, and viral infections can occur. Should any type of skin infection occur, additional treatments or medical antibiotics may be necessary.
6. Bleeding: Pinpoint bleeding is rare but can occur following treatment procedures. Please follow the after-care instructions to prevent infection.
7. Allergic Reactions: Pigments may induce severe allergic reactions if you are allergic to tattoo ink or topical ointments (like Neosporin).
8. I understand that exposure of my eyes to light could harm my vision. I must keep eye protection goggles on at all times.
9. Compliance with aftercare guidelines is crucial for healing and preventing skin tone changes.

Occasionally, unforeseen mechanical problems may occur, and your appointment will need to be rescheduled. We will make every effort to notify you in advance.

We may use photographs taken before or after treatments for assessment or training. These will be used anonymously and only include the treated area.

Acknowledgment:

My questions regarding the procedure have been answered satisfactorily. I understand the procedure and accept the risks. I hereby release , its staff, and medical director from all liabilities associated with the above indicated procedure.