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LaserLite Solutions

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Reason for care

Select date & time

1 Appointment info

2 Prescreener

Reason for care

3 Contact information

What is the primary reason you are seeking care?

Which type of service are you requesting?

Consultation Only Laser Treatment Photobiomodulation (PBM) Therapy Not Sure — I would like guidance

Were you referred by a healthcare provider? (If yes, please provide the provider or clinic name)

Which area are you seeking treatment for?

Face Beard or jawline Scalp Neck Upper body Lower body Multiple area Airway or snoring therapy

How would you describe your skin tone?

Very light Light Light to medium Medium Medium to deep Deep

Do any of the following currently apply to you?

Recent laser, IPL, or energy–based treatment in the same area Recent chemical peel, microneedling or resurfacing treatment Recent tanning, sunburn or prolonged sun exposure Isotretinoin (Accutane) use within the past 6 months Active infection, open wound, cold sore, or rash in the treatment area New or recently changed prescription medications Pregnancy or breastfeeding History of keloid or abnormal scarring None of the above

Are you seeking same-day treatment if clinically appropriate?

Yes No, consultation only

Acknowledgement

I understand that not all individuals are candidates for same-day treatment. Treatment decisions are based on clinical assessment and safety considerations determined by the practitioner

Yes, I understand

For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.

LaserLite Solutions

Etobicoke Canada

Main Location

407 - 190 Sherway Drive
Etobicoke Canada, ON M9C 5N2

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THE CLIENT PORTAL IS NOT TO BE USED FOR EMERGENCY SITUATIONS. IF YOU OR OTHERS ARE IN IMMEDIATE DANGER OR EXPERIENCING A MEDICAL EMERGENCY, CALL 911 IMMEDIATELY.