Co2 Laser Consent Form
I understand that the fractional co2 laser is a laser device designed for ablative skin resurfacing and that clinical results may vary in different skin types.
Co2 laser consent form. This form is intended as a sample form. Fraxel dual is a non ablative fractionated laser. Matrix fractional co2 laser client informed consent. Medications are available to treat such complications but in rare cases.
The nature of the fraxel restore dual procedure has been explained to me. Fractional co2 laser consent form dr. Laser energy is not ionizing radiation i e. Fraxel treatment consent initial that you have read and understand this page.
Co2 laser skin resurfacing consent form. Please read this document carefully. Patient name date. Before signing this document please ask your physician about any aspect of.
It contains the information omic recommends you as the surgeon personally discuss with the. For translated forms please visit the consent forms in spanish page. These glasses are specific to the type of laser. Welcome to omic s consent form library a collection of loss prevention and patient education templates for ophthalmic practices sample letters and office forms are included under the patient or practice categories.
I understand there is a possibility of short term effects such as. Place letterhead here and remove note. A co2 laser uses a wavelength of 10 600 nm which makes water molecules the effective target of the laser energy. Steven c spencer michelle osborne spencer pa amanda smith pa c.
Fractional co2 laser uses beamlets of energy light to bore tiny holes in the skin which works to. Use of a laser for dental treatment hard and or soft tissue and root canal is a very safe and predictable form of treatment. Some individuals have a tendency to form raised or thickened scars and this may be unpredictable. A preview is displayed below.
I declare that i understand the following information the goal of co 2 laser skin resurfacing surgery is to reduce or partially eliminate facial wrinkles or reduce scarring from skin conditions such as acne. Safety glasses are worn to protect the eyes from any unforeseen effects. The water within the skin is rapidly heated causing heating of the deep dermis which stimulates to form new collagenand elastinhelping to increase skin turgor and thickness tightness and tone. Do not sign this form without reading and understanding its contents.
It is photo thermal produces heat. Co2 laser skin resurfacing consent for treatment. Informed consent and release form cortex fractional co 2 laser treatment as a patient it is important for you to understand the expected results and risks of fractional co 2 skin resurfacing with the cortex co 2 laser system. Change font size for large print.