Consent Form

I hereby request  an Apex Pain Relief Laser Therapy Assessment.   I have had the opportunity to discuss the nature and purpose of this Assessment and  I also understand that results are not guaranteed. 

I understand that Pain Relief Laser Therapy is a medical treatment that uses specific wavelengths of light to impart energy into injured cells and tissues. This energy is transformed from photon energy to biochemical energy in the cells, which can then be used for accelerated healing in the body. The expected direct outcomes from laser treatment may include reduced inflammation, reduced pain, and repair of tissues. The indirect outcomes may include increased ranges of motion, comfort and activity levels. Alternatives to cold laser therapy include, but are not limited to, exercise therapy, anti-inflammatory or anti-pain medication, ultrasound, massage therapy, chiropractic or physiotherapy.

I further understand and am informed that, as in all health care, in the practice of Pain Relief Laser Therapy there are some risks, including but not limited to short term aggravation of symptoms and skin irritation. I understand that I must disclose all relevant information of my health-related issues (including medication) to the practitioners at the clinic. Treatment over active cancer may increase the rate of tumour growth; I understand that I must therefore disclose any history of cancer and confirm that I am not fitted with a pacemaker, am not pregnant and do not suffer from any form of epilepsy. I also understand that the laser can cause damage to the eyes when viewed directly, and that my practitioner will provide me with eye protection where necessary. 

I do not expect the practitioners at Apex Laser UK Ltd to be able to indicate or explain all risks and complications and I wish to rely on the exercise of my judgement during the course of assessment and/or procedures which the practitioners feel at the time, based upon the facts known, is in my best interest. 

I consent to the Assessment to determine whether or not Apex Pain Laser Therapy is appropriate for my condition/symptoms . I intend this consent to apply to all my present and future care with Apex Laser UK Ltd.

I further confirm that I will NOT discontinue any prescribed course of medication until such time as I have discussed this matter with my GP or medical advisor and have gained his/her consent.