BBL (Broad Band Light) Informed Consent From

The information I have received is correct to the best of my knowledge, and I have not withheld any known medical state or condition. I will inform the Laser operator before treatment if there has been any change (for example medications taken)

I understand the results from this treatment vary considerable and a small percentage of people will not respond satisfactorily to treatment

I understand multiple treatments are necessary to achieve satisfactory results.

I understand there are no guarantee of permanent results and maintenance treatments may be necessary

I understand that I must avoid sun exposure on treated area for the duration of the treatment (and up to one month afterwards) or use a high sun protection to avoid sun damage.

I understand tanned skin cannot be treated, I understand treatment times are booked at specific durations between sessions. If unable to treat due to tanning this may impact results.

I understand that there may be short-term side effects such as: reddening, bruising, swelling, mild burning or blistering, hypo-pigmentation (lightening of the skin), or hyperpigmentation (darkening of the skin), as well as rare side effects such as scarring and permanent discolouration.

I understand that pigmented areas caused by sun damage may initially turn darker. This will be followed by "micro-crusting" of the lesion, after which it should flake away leaving an area without excessive pigmentation

I understand I must wear protective eye goggles to prevent damage from the laser.

I understand that the Sciton BBL is intended for benign vascular and pigmentated legions, and/or permanent hair reduction and that clinical results may vary in different skin types. I understand that there is a possibility of rare side effects such as scarring and permanent discoloration as well as short term effects such as reddening, oedema, mild bruising and temporary discolouration to the skin. These effects have been explained to me.

Based on the experience of other physicians we have found those people who tend to sunburn rather than tan, usually obtain good results on the first and subsequent visits. On the other hand, those who tan more easily tend to have more variation in their results. Some patients will experience partial results and some will experience no improvements at all.

To photographs and other audio-visual and graphic materials before, during, and after the course of my therapy to be used for medical, marketing, and education purposes. Although the photographs or accompanying material will not contain my name or any other identifying information, I am aware that I may or may not be identified by the photos.

I have read and understand all information presented to me before signing this consent form. I have been given an opportunity to have all of my questions answered to my satisfaction. I understand the procedure and accept the risks. By signing this consent I agree to the terms of this agreement.