Templates · Free template · Laser consent

Laser Hair Removal Consent Form Template

A printable consent form for laser hair removal that combines a short health screening with the risks, pre- and post-treatment rules, and realistic expectations a client should understand before the first session.

Jump to the template ↓

Last reviewed September 2026 · Not legal advice

Part of the Laser hair removal treatment guide →

What a laser hair removal consent should cover

The form should establish that the client has been screened, understands how the treatment works, and knows the risks: temporary redness and swelling, and less commonly pigment change, blistering, or burns. It should also state the practical rules, such as no sun or tanning before and after and no plucking or waxing between sessions.

Expectations belong on the form too. Laser reduces hair over a series rather than removing it permanently in one visit, and results vary with hair colour, skin type, and hormones. Setting that out in writing prevents most disagreements later.

Clinic name · address · phone

Laser Hair Removal Consent Form

Client

Full name

Date of birth

Phone

Screening

Currently pregnant or breastfeeding? Yes No

Taken isotretinoin in the past 12 months? Yes No

Taking photosensitising medication? Yes NoIf yes, details

Sun exposure, tanning, or self-tanner in the past 2 weeks? Yes No

History of keloid scarring or cold sores? Yes NoIf yes, details

Any skin condition, tattoo, or implant in the treatment area? Yes NoIf yes, details

Risks and acknowledgements

Initial each item to confirm you have read and understood it.

InitialsI understand that laser hair removal reduces hair over a series of sessions and does not guarantee permanent removal.

InitialsI understand the risks include redness, swelling, temporary pigment change, blistering, scarring, and, rarely, burns.

InitialsI agree to avoid sun exposure and tanning before and after treatment and to use SPF.

InitialsI agree not to pluck, wax, or thread between sessions, and to shave as instructed.

InitialsI have disclosed all medications and relevant medical history accurately.

Consent

Areas to be treated

I consent to a test patch if recommended
I have had the chance to ask questions
I consent to treatment

Signatures

Client / patient signature

Date

Practitioner name and signature

Date

Template from zdrovia.ca/templates/laser-hair-removal-consent-form/ · Review with your medical director, regulatory college guidance, and insurer before use.

Send this form before the appointment instead of printing it

Zdrovia's form builder turns this template into a digital form your clients sign on their own phone. The signed copy files into their chart with the exact version they saw, and photo consent stays separate from treatment consent. It's free for solo practitioners, with data stored in Canada.

Start free, no card required See how digital forms work →

See how Zdrovia is set up for laser clinics.

Frequently asked questions

Do I need a new consent form for every session?

Many clinics have the client sign at the start of a series and confirm changes in health or medication at each visit. Your insurer and regulator may set their own expectations.

Should the form promise permanent hair removal?

No. It should describe reduction over a series. Overpromising is a common source of complaints.

This template is a starting point for discussion with your team and advisors, not legal or medical advice. Requirements vary by province and profession. Have your medical director, your regulatory college's guidance, and your malpractice insurer confirm the wording before you use it with patients.