Phototherapy Consent Form
A standardised legal and clinical document obtained from a patient prior to commencing ultraviolet light treatment, recording discussion of indications, risks, alternatives, and the patient's informed agreement.
Full Definition
A phototherapy consent form is completed before initiating any ultraviolet-based treatment regimen (narrowband UVB, broadband UVB, or PUVA) and must include the patient's diagnosis, the proposed phototherapy modality, anticipated number of sessions, risks (erythema, blistering, photoageing, theoretical carcinogenesis), contraindications reviewed, and alternative treatments offered. Editors reviewing these documents must verify that the treatment modality is named precisely (e.g., 'narrowband UVB' not simply 'UV treatment'), that all risks fields are populated, and that the patient signature line and clinician countersignature are present. PUVA-specific consent must additionally reference the use of psoralen and ophthalmological protection requirements.
Usage
Usage note: Specify the phototherapy modality in full on the form; 'UV treatment' alone is insufficient. PUVA consent must include psoralen-specific risks. Ensure compliance with local consent policy and that both patient and clinician signatures are present.
In Context
- "The phototherapy consent form was reviewed and signed by the patient prior to the first narrowband UVB session." — Phototherapy unit documentation
- "The editor noted that the phototherapy consent form referred only to 'light therapy' and queried whether the specific modality should be identified." — Document quality review