Consent Release Form

Red Light Therapy Bed (LLLT – Low Level Light Therapy or PBMT – Photobiomodulation Therapy)

Before undergoing Red Light Therapy, please read the following important information and guidelines:

Safety Precautions:

• Protective eyewear during sessions is optional based on light sensitivity. Eye protection is available for your session if desired.
• Ensure your skin is clean and free from deodorants, makeup, fragrances, oils, lotions, and jewelry before the session.
• Be aware that certain medications or cosmetics might increase your skin’s sensitivity to Red Light Therapy.
• It’s recommended to follow a red light therapy schedule of 1-3 days per week for 4-12 weeks for optimal results.
• Post-session, take a moment before getting up to prevent dizziness.

• Drink at least 8 oz. of water before and after RLT sessions.
• Maintain healthy eating habits and limit alcohol consumption and smoking before therapy sessions.

• Red Light Therapy is non-invasive and doesn’t produce thermal damage or pain.
• Report any unusual sensations or problems to the facility immediately.
• If you have or have had any of the following conditions, you are not eligible for red light therapy unless approved by your attending physician: Photophobia, Porphyria, Lupus Erythematosus, Exogenous Eczema, Eye Disease/Retinal Abnormalities, Epilepsy and Seizures, Hypomelanism (albinism), Heart Trouble/Pacemaker or Pregnancy.
• Individuals with Infectious or Contagious conditions may not use our RLT equipment.

• If you have consumed any of the listed photosensitive medications or herbs in the last 7 days, please notify the facility.

Financial Policy:

• Payment is required for all services rendered.
• No refunds for treatments/services already received.
• A “no show fee” equal to the session price applies unless a 24-hour notice of cancellation is provided.
• All sales are final.