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הסכמה להסרת שיער בלייזר

הסכמה מדעת להסרת שיער בלייזר ו־IPL עם בדיקת סוג עור, חשיפה לשמש ותרופות

נסה את הטופס שלקוחותיך יראו

מלא את הטופס כפי שלקוחותיך יעשו — כל שדה, כל שאלה תנאית, כל סימן התנגדות. לא נשמר ולא נשלח.

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הסכמה להסרת שיער בלייזר

פרטי הלקוח

פרטי הטיפול

היסטוריה רפואית

סיכונים והסתבכויות

Potential Risks and Complications:

- Redness, swelling, and a sunburn-like feeling for a few hours to days
- Blistering or crusting (uncommon)
- Hyperpigmentation or hypopigmentation — darker or lighter patches, usually temporary but occasionally lasting, more likely with a tan or darker skin types
- Paradoxical hair growth — new fine hair near the treated area, especially on the face and neck
- Scarring (rare)
- Eye injury if protective eyewear is not worn

Laser hair removal reduces hair; it is not permanent removal. A course of 6–8 sessions, 4–8 weeks apart, plus maintenance is typical. Avoid sun exposure and use SPF 30+ on treated areas for 2 weeks before and after each session.
I understand that results vary with hair color, skin type, and hormones, that gray, white, red, or very fine hair responds poorly, and that multiple sessions and maintenance are required.
I understand that tanned or sun-exposed skin greatly increases the risk of burns and pigment changes and I agree to avoid sun exposure and self-tanner before and after treatment.

הסכמה וחתימה

I voluntarily consent to laser or IPL hair removal treatment. I have been informed of the benefits, risks, alternatives, and potential complications, including the possibility of burns and pigment changes. I understand this is an elective cosmetic procedure and no guarantee of outcome has been made. I release the provider and practice from liability related to this treatment except in cases of negligence.
I confirm I have read and understood the above information and give my informed consent.
חתום למעלה באצבע או בעכבר

תצוגה בלבד — לא נשמר, לא נשלח ולא מאוחסן.