Latisse consent form 2026

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  1. Click ‘Get Form’ to open the Latisse consent form in the editor.
  2. Begin by filling in your name at the top of the form, ensuring it is clear and legible.
  3. Review the contraindications section carefully. Acknowledge any allergies or conditions that may affect your eligibility for Latisse.
  4. In the side effects section, read through the potential risks associated with Latisse. This will help you make an informed decision.
  5. Follow the instructions under 'Use' to understand how to apply Latisse correctly. Make sure to note important details like not applying it to bottom lashes.
  6. Finally, sign and date the form at the bottom, confirming your understanding and agreement to proceed with treatment.

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Almost everyone and anyone who wants to achieve those beautiful and long eyelashes can qualify for the treatment. With that being said, the candidate must: Be in good physical health.
Dr. Fiona Wright, Cosmetic Physician: LATISSE® does not work in place of mascara, but rather is a treatment to grow lashes for those with inadequate or not enough lashes and requires a prescription from a doctor.
Dr. Jeanine Downie, Dermatologist: My patients ask me this all the time. LATISSE® is the first FDA-approved product to grow lashes longer, fuller and darker for those who do not have enough lashes. It has been studied for safety and efficacy and is available only by prescription.

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Depending on your state's physician dispensing laws, you can offer LATISSE® by physician dispensing or by having your patients fill their prescription at the pharmacy. Place an order with your Allergan representative. Call Customer Service at 1-800-377-7790.
Answer: Latisse Anyone with prescribing abilities can get latisse but it is always best to get it from a physician who is experienced with using it. This will usually be an aesthetic physician or ophthalmologist.
Revitalash is an over-the-counter lash growth formula that contains a smaller amount of the prostaglandin latanoprost. This works the same as the active ingredient in Latisse (Latisse has the patent on theirs) but is found in a smaller amount, which is why it is available without a prescription.
Eye irritation or dry eyes may be a side effect from regular LATISSE use, which could lead to other visual complications. Macular edema, or a buildup of fluid in the macula (the center of the retina), has been a reported side effect of LUMIGAN treatment for high intraocular pressure.
Average 12 Month Prices for Latisse (Brand) (Generic) PharmacyLatisse Retail PriceBimatoprost Retail PriceCVS Pharmacy$153.99$126.18Walmart$154.23$138.90Walgreens$153.74$134.39Kroger Pharmacy$158.83$157.602 more rows

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