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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 for your visit?

Which type of service are you requesting?

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

Were you referred to LaserLite Solutions?

No Yes, by a physician Yes, by another healthcare professional Yes, by family or friends Yes, by another source

Which area are you seeking treatment for?

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

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 Started or changed prescription medications within the past 30 days Pregnancy or breastfeeding History of keloid or abnormal scarring None of the above

If clinically appropriate, would you like to receive treatment on the same day as your consultation?

Yes No

Acknowledgement

I understand that submitting this prescreener does not guarantee treatment. Candidacy and same-day treatment are determined following clinical assessment and safety screening 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

647.260.0563 |

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.