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fblt test
consent
This form is a tool to help your clinician determine if you are a candidate for compression therapy. Please check YES or NO to the questions below:
Are you sensitive to light?
Yes
No
By signing below, I acknowledge that I have been informed about the nature of Red Light Therapy, its potential risks and benefits, and its contraindications. I hereby give my consent to receive this treatment as prescribed and deemed therapeutically necessary based on the findings during the screening process.
