Ear treatment consent

WorxClinic Wax Removal Information & Consent

Read the full handout below, then complete the online screening questions and consent acknowledgement. The clinic will receive the submission by email.

Use olive oil spray for 3 to 5 days before your appointment.Appointments last around 30 minutes.Some people feel briefly dizzy afterwards, but it usually settles quickly.

Information

Understanding Ear Wax

WorxClinic provides a safe, gentle, and professional ear wax removal service. Alongside specialist training in ear care, the clinic is led by a registered Advanced Nurse Practitioner with NHS experience across primary and secondary care.

Ear wax (cerumen) is a natural substance that lubricates and protects the ear canal. It helps keep the ears clean and reduces the risk of infection. Sometimes, however, wax can build up and cause symptoms such as reduced hearing.

  • Naturally producing a larger amount of wax
  • Wax becoming drier with age, making it harder for the ear to self-clean
  • Narrow or hairy ear canals
  • Regular use of hearing aids, cotton buds, ear plugs, or earphones
  • Bony growths in the ear canal

Symptoms may include hearing loss, tinnitus, itchiness, dizziness, or infection.

Treatment

Ear Irrigation

Ear irrigation is a safe and effective method for removing softer, non-impacted wax. It replaces the older technique of syringing. Warm water is gently introduced into the ear canal using a controlled electric pump, and the wax is flushed into a collection cup.

The procedure should not be painful, but there are possible side effects.

  • Ear canal discomfort or pain
  • Infection
  • Tinnitus, dizziness, or vertigo
  • Further impaction of wax
  • Trauma to the ear canal or ear drum, including perforation
  • Mastoiditis, which is an infection of the bone behind the ear
  • Temporary or, rarely, permanent hearing loss

Suitability

Who May Not Be Suitable for Irrigation

Irrigation may not be advised if you have any of the following. If any apply, tell the clinician before treatment starts.

  • A recent or past ear drum perforation
  • Previous ear surgery, for example mastoidectomy
  • Grommets currently in place or removed within the last 18 months
  • Current ear pain or infection, or infection within the last 6 weeks
  • A cleft palate, even if repaired
  • A foreign body in the ear
  • Blood-thinning medication

Please let the clinician know if any of these conditions apply to you.

Alternative treatment

Microsuction

Microsuction is another safe and effective method of wax removal. A small suction device gently removes wax from the ear canal, and it is suitable for most people.

  • Difficulty keeping the head still
  • Sensitivity to loud sounds
  • A history of severe dizziness
  • Possible discomfort, pain, perforation, infection, tinnitus, dizziness, or vertigo

Appointment

Your Appointment at WorxClinic

Before your appointment, please use olive oil spray such as Earol for three to five days. Spray into each ear twice daily. If the wax is impacted, you may need to do this for up to two weeks.

Appointments last around 30 minutes. The clinician will explain each step, answer questions, and ensure you feel comfortable throughout.

  • If you have had irrigation, keep your ears dry for a few days while a new protective layer of wax forms.
  • If you have had microsuction, you do not need to keep your ears dry.
  • For ongoing ear health, regular use of olive oil spray is recommended.
  • If wax removal is unsuccessful, you may be asked to continue olive oil drops for another week before a follow-up appointment.
  • If no wax is present, only a consultation fee will apply and you may be advised to see your GP to explore other causes of symptoms.

Consent

What Happens Next

The form below repeats the screening questions from the handout and captures the emergency contact details the clinic needs before treatment can start.

If you are unsure about any answer, select Yes and give a brief explanation in the details box.