Tattoo Removal Consent Form

The Tattoo Removal Consent Form is designed for laser tattoo removal clinics, medical spas, dermatology practices, and aesthetic medicine offices that perform tattoo removal using Q-switched lasers, picosecond lasers, or other laser-based technologies. As the tattoo removal industry continues to grow, providers need a thorough consent process that documents the treatment plan, manages patient expectations about the number of sessions and degree of removal achievable, and ensures full disclosure of the risks inherent in laser skin procedures. This laser tattoo removal consent form captures all the clinical and administrative details required for safe, compliant practice.

The form begins with patient demographics and a detailed description of the tattoo being treated, including location, approximate size, ink colors present, age of the tattoo, and whether any prior removal attempts have been made. A Fitzpatrick skin type assessment helps the provider determine appropriate laser settings and counsel the patient on their specific risk profile for complications such as hypopigmentation, hyperpigmentation, scarring, or incomplete removal. Patients are asked about medical history factors that affect treatment outcomes, including keloid tendency, photosensitivity, current medications (especially photosensitizing drugs), autoimmune conditions, and pregnancy status. The photo documentation section authorizes the clinic to take before-and-after photographs for treatment tracking and, optionally, for marketing use.

The consent section provides a detailed explanation of the laser tattoo removal process, expected sensations during treatment, realistic outcome expectations based on ink colors and skin type, potential side effects and complications, aftercare requirements, and the typical number of sessions needed. Patients acknowledge that complete removal is not guaranteed, that multiple sessions spaced weeks apart are required, and that certain ink colors may be more resistant to treatment. An integrated payment section collects a deposit or session fee, and the form concludes with the patient's legally binding electronic signature confirming their informed consent to proceed with the tattoo removal treatment plan.