Cosmetic Practice Forms

Cosmetic practice and surgery forms, patient intake forms, post op instruction guides, pre-op guides, botox, restylane, personal history, routing slip, superbill, super bill, patient history, patient sign in, botox consent form, new patient, new client, photography release, video release, interview release forms, and more.

$40.50 $24.00

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.


$40.50 $36.45

A 2 page, Botox®, 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.


$43.20 $22.68

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.


$108.00 $52.65

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.


$58.50 $36.45

A more complete, 3 page, 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, it also informs of risks and alternative treatments.

It is divided into several sections, Instructions; Introduction, what Restylane is, what it has been approved for, and general information about the effects; Alternate Treatments; Risks of Restylane; Normal Occurrences During Tissue Filler Injections, Including Restylane; Complications and Health Insurance.

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.


$22.50 $20.25

Pre treatment instructions for Restylane® treatment, leaflet with instructions for patients who will be receiving Botox injections. What to expect, what to do prior to treatment, what to do 24 to 48 hours before treatment, additional recommendations and notice of who should not be treated with Restylane. To avoid legal issues be sure you patient is well informed, before and post treatment.


$22.50 $20.25

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.


$108.00 $52.65

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.


$22.50 $20.25

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


$49.50 $28.35

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.


$40.50 $20.25

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.


$37.80 $34.02

This form recognises that there are patients, members of the community who cannot speak English, and others that have other communication needs. This translation statement is intended to ensure that measures are in place across the office to support communication with everyone whose first language is not spoken english, does not communicate by the spoken work or has any form of communication difficulty.

The form acknowledges that the health care or interpreter has explained the procedure or course of treatment to the patient to the best of his/her ability and acknowledges that he/she believes the patient has understood. Signature and date lines for patient and interpreter.

Protect your rights, be sure non English speaking patients have had all procedures explained, what procedure is likely to involve, including risks, alternative treatments, including no treatment and any particular concerns to patient and that he/she fully understood, avoid legal issues along the way.

Did You Know?  Responsibility for arranging translation or interpreting services lies with the organisation and not the service user.