Forms for use in cosmetic practice centers, centers for cosmetic surgery, plastic surgeons, healthcare, medical offices.
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.
A list of frequently asked questions about Botox and Botox injections, patient handout / leaflet. Easily editable using word processor.
This notice describes to your clients and patients how medical information about them may be used and disclosed and how the patient can get access to this information.
The Health Information Portability and Accountability Act of 1996 (HIPAA) is a federal program that requires that all medical records and other individually identifiable health information used or disclosed by a physician, whether electronically, on paper, or orally, are kept properly confidential. This Act gives the patient, significant new rights to understand and control how their health information is used. HIPAA provides penalties for covered entities that misuse personal health information. This information provided to client or patient is required by HIPAA.
A patient's guide and checklist for patients using CPAP and BiPAP medical, therapy equipment.
General Restylane®, facial injections consent form. Patient authorizes physician to perform Restylane injections into muscles covering patient's forehead, face, chewing muscles, scalp, neck, or upper back. Form may be modified or edited to meet your own practice needs and or other types of fillers and treatments.
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.
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.
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 form is used used to obtain new patient medical history. Form is divided into 4 sections. Patient information, past medical history, medications, and the last section is reserved for women only. May be used as is, or easily personalized to your individual needs, using compatible word processor.
No need to design your form from scratch, 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 starting from a new form or form typesetting and offset printing fees. Print as many as you need and edit them as often as needed.
Our referral card provides information that is easy to read and understand for you and your referring doctor. Layout is tailored to your practice and the specific services you offer.
Easily edit using Microsoft Word and print from your office in regular bond paper or thicker stock, print as many as you need. 2 will fit on 8.5" x 11" letter size paper.
This release form is used to obtain client authorization to take before and after photographs for documentation purposes. It also grants the physician, if agreed by the client, permission to use such photographs in other types of publications.
A welcome form, sure to impress your clientele upon receiving it. Learn more about your own clients by obtain information as to the primary reason why they are visiting your cosmetic practice, why they selected your practice and also inquires about other cosmetic procedures they may be interested in being informed and their preferred payment option(s). Easily edit the form to your particular questions using Microsoft Word or other compatible word processor.
Botox® Treatment Consent to Treat a Minor Form. The parent or guardian of a minor, authorizes physician to perform cosmetic treatment and is disclosed information concerning Botox, how it injected, side effects, what to expect, patient also acknowledges the limitations of Botox treatments and possible side effects and dangers. Patient consent date and signature signature lines at bottom of form. Physician should examine form to see if it may benefit his/her practice to help keep patients legally informed and physician from legal problems.
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