Forms for use in cosmetic practice centers, centers for cosmetic surgery, plastic surgeons, healthcare, medical offices.
Proper, specific, and reproducible labeling of anatomic locations of dermatologic lesions or therapy is important to record as part of a patient's medical history. These drawings can serve as a list of locations treated (e.g. with Botox, etc.) proving very useful on patient's next visit.
A form authorizing the clinic or doctor's office to charge a patient, certain amount of money if the patient misses his/her's scheduled appointment day, unless said patient informs the clinic or doctor, within a certain amount of hours in advance to cancel or make other scheduled appointment.
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 form is used provided to client by physician so he can obtain a comprehensive breast history prior to considering breast surgery.
Includes both, sections for written responses and multiple choice using check boxes. Fully edit the questions to your particular practice needs.
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.
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.
The super bill is bundled with Microsoft Word forms and a fillable PDF form for use with free Adobe Reader. Both forms can be personalized with your practice name, address, contact numbers, etc. The Word form is fully editable, the PDF form you can only edit your practice business name, address, etc.
General botox, facial injections consent form. Patient authorizes physician to perform Botox 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.
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..
A patient's guide listing frequently asked questions about Restylane® and Restylane injections, patient handout / leaflet. Easily editable using word processor.
Put your clients at ease and provide them with Restylane injection information.
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.
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.
General cosmetic surgery preoperative and post-operative guidelines will help to help your clients and patients to adequately prepare ahead of time. Avoid emergencies and legal issues, be sure that your patients follow your exact pre-op and post-op instructions. Easily edit the form to your particular questions using Microsoft Word or other compatible word processor.