I hereby authorize Dr Elijah or any delegated associates to perform Laser Genesis non-ablative skin therapy on me. I understand that this procedure works on promoting vibrant and healthy looking skin by creating a thermal response in the dermis that stimulates new collagen. I understand that multiple treatments are required and it is possible the result will be minimal or not help at all.
I am aware of the following possible risks:
1. discomfort- slight warming sensation
2. redness/swelling/bruising- short term risks
3. pigment changes- during the healing process, I may get lighter or darker pigment at the treatment area, this is usually temporary, but on rare occasion can be permanent
4. wounds- treatment can result in burning, blistering, or bleeding of the treatment area
5. infection- infection is possible whenever the skin surface is disrupted. Proper wound care should prevent this
6. scarring - this is a rare occurrence, but it is possible if the skin surface is disrupted.
7. eye exposure- protective eyewear will be provided
The following points have been discussed with me:
potential benefits of the proposed procedure
possible alternative procedures such as topicals, microdermabrasion, or surgery
probability of success
reasonably anticipated consequences if the procedure is not performed
most likely possible complications/risks involved with the proposed procedure and subsequent healing period.