Forms for use in cosmetic practice centers, centers for cosmetic surgery, plastic surgeons, healthcare, medical offices.
This form is used used to obtain new client or patient, allergy and medication information. It has room for patient's personal information, allergies, medicines, vitamins and other supplements and for any insulin taken and dosage, keep in mind that form fields can be edited using Microsoft Word or other word processor..
With its contemporary design and host of features, it is sure to enhance any cosmetic practice or existing medical or doctor's office wanting to do away with their old patient intake forms and replace them with new, updated, contemporary forms without going through the expense of new form typesetting and offset printing fees. Print as many as you need and edit them as your office needs change in time.
An Authorization for Disclosure of Health Information is an individual's signed permission to allow a covered entity to use or disclose the individual's protected health information (PHI) that is described in the Authorization for the purpose(s) and to the recipient(s) stated in the Authorization.
The form's purpose is to obtain patients signature to be able to use or disclose health information.
English and Spanish bundled together.
An office, sign-in register for patients to sign-in when they enter the office.
Form may be printed in your office and only print the amount you need or may be delivered to your local print shop for quantity printing.
This New Client Information form can be used to obtain patient information as an intake or registration form. Its contemporary and clean design makes it easy for clients/patients to read and answer the questions. May be used as is, or easily editable using Microsoft Word to assist you in asking only the questions that you wish to obtain from your patients.
This is a Botox Fee Schedule (or for any other type of dermal filler or any type of procedures where you wish to have a price list), includes procedures, prices, payment schedule and signature line for client. May also be used as a fee schedule form for any other type of surgical procedures, easily edit and change form fields to best meet your needs.
This Planning for Cosmetic Surgery brochure is a great planning toolkit and a helpful resource to answer your patient's general questions and address basic information that may be relevant to their plastic surgery experience. Patient safety should be your highest priority and informing your patients will be your biggest asset. Teaching your patients about their options will help them be educated patients, better prepared for physician consultations and ready to decide on which procedure is right for them.
This is a great brochure and editable using Microsoft Word. Easy to personalize, once completed, print, in your office, as many as needed, or deliver camera-ready artwork to your local speedy printer or print shop, for quantity brochure printing.
Provide your clients and customer with a welcoming letter showing that you respect their rights to dignity and pride with the Patient's Rights notice / handout.
This document will explain your patient rights and responsibilities. It is part of your patient's registration and is an important part their health care. Our commitment to your patients should include and inform them of their rights and responsibilities. This notice complies with applicable Federal civil rights laws and affirm that the clinic will deliver high-quality health care to every patient
A superbill is a form used by medical practitioners and clinicians so they can quickly complete and submit the procedure(s) and diagnosis(s) for a patient visit for reimbursement. It is generally customized for a provider office and contains patient information, the most common CPT (procedure) and ICD (diagnostic) codes used by that office, and a section for items such as follow-up appointments, copays, and the provider’s signature.
Superbills aggregate the data from a patient visit needed to successfully submit an insurance claim. This includes provider information, patient information and visit information. Superbills are different from receipts/invoices because they provide additional information regarding the visit (diagnosis and procedure codes) that are needed to get a claim approved.
General Restylane® post-treatment guidelines will help to help your patients to adequately prepare after the treatment. Avoid emergencies and legal issues, be sure that your patients leaves your office with post-treatment instructions to follow by providing them with this form and keep an office copy. Easily edit the form to your particular instructions using Microsoft Word or other compatible word processor.
Avoid malpractice suits that can tarnish the physician's reputation and raise malpractice insurance premiums by having your client accept binding arbitration of any dispute, avoiding the client's right to a trial.
The form's purpose is to obtain patients signature acknowledging that patient received the HIPAA Privacy Practices Notice.
Did You Know? Under the HIPAA Privacy Rule, the local health department is required to disseminate its Notice of Privacy Practices to all patients upon the first delivery of service after April 14, 2003, and to make a good faith effort to obtain the patient's acknowledgment that he or she has received the Notice.
This form functions as a Prescription and Letter of Medical Verbal Orders for healthcare equipment, medications and special orders. Form also records doctor and patient information.
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