Home
Forms Library
CONSENT FORM FOR AREOLA REPIGMENTATION (2)

Get the up-to-date CONSENT FORM FOR AREOLA REPIGMENTATION (2) 2025 now

CONSENT FORM FOR AREOLA REPIGMENTATION (2) Preview on Page 1

Show details

4 out of 5

33 votes

The document is a consent form for areola repigmentation, detailing personal information, medical history, and allergies of the client. It includes a release and waiver agreement acknowledging the risks associated with the procedure, as well as aftercare instructions. The client must confirm their understanding of the treatment process and agree to hold harmless the practitioner and associated establishments.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

The best way to edit CONSENT FORM FOR AREOLA REPIGMENTATION (2) online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

With DocHub, making changes to your paperwork takes only some simple clicks. Make these quick steps to edit the PDF CONSENT FORM FOR AREOLA REPIGMENTATION (2) online free of charge:

Register and log in to your account. Log in to the editor using your credentials or click on Create free account to test the tool’s functionality.
Add the CONSENT FORM FOR AREOLA REPIGMENTATION (2) for editing. Click the New Document option above, then drag and drop the file to the upload area, import it from the cloud, or using a link.
Adjust your template. Make any changes needed: add text and photos to your CONSENT FORM FOR AREOLA REPIGMENTATION (2), underline details that matter, erase parts of content and replace them with new ones, and add icons, checkmarks, and fields for filling out.
Finish redacting the template. Save the updated document on your device, export it to the cloud, print it right from the editor, or share it with all the parties involved.

Our editor is very easy to use and efficient. Give it a try now!

See more CONSENT FORM FOR AREOLA REPIGMENTATION (2) versions

We've got more versions of the CONSENT FORM FOR AREOLA REPIGMENTATION (2) form. Select the right CONSENT FORM FOR AREOLA REPIGMENTATION (2) version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2010	4 Satisfied (33 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is areola pigmentation treatment?

A: The darker your skin pigment is, the more likely you are to lose some of the /areola pigment. However, the pigment typically returns in full a few months following surgery. In the rare incident that the pigment does not return 100%, you may tattoo the area.

Does areola pigment come back?

Now, lets get into the cost of an areola tattoo. The cost can vary depending on several factors, including the location of the tattoo artist, the complexity of the tattoo design, and the amount of pigment used. On average, an areola tattoo can cost anywhere from $600 to $1,500.

What is areola tattooing for?

If a woman chooses to have areola tattooing, it is the final step of reconstruction after a mastectomy if the was removed as part of the surgery. It involves tattooing a on the skin that may have details that make it look more realistic than a reconstruction might.

What is the CPT code for areola tattooing?

In addition, tattooing of the -areola as part of reconstruction (Current Procedural Terminology [CPT] codes 11920, 11921, 11922) is considered medically necessary and covered when performed by a physician or licensed tattoo artist.

What is areola repigmentation?

Cosmetic tattooing techniques and color pigments are used to create the appearance of an areola. For a unilateral mastectomy patient, this process helps the reconstructed to match the natural . For patients with bilateral reconstruction, both areolas are recreated.

What needs to be on a tattoo consent form?

Key Components of a Consent Form Every effective tattoo consent form should include certain key elements: 📝 Client Information: Full name, contact details, and age verification. 🏥 Medical History: Questions about allergies, skin conditions, and medical conditions that might affect the tattooing process.

Get the up-to-date CONSENT FORM FOR AREOLA REPIGMENTATION (2) 2025 now

Here's how it works

The best way to edit CONSENT FORM FOR AREOLA REPIGMENTATION (2) online