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.

$22.50 $20.25

The form is intended to clarity, to client/patient of their financial responsibility with medical services and procedures.


$49.50 $30.78

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.


$49.50 $28.35

Botox Treatment Consent Form. Patient 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.


$22.50 $20.25

A correspondence form to assist in communication and the sharing of information between patient and doctor is important piece. Each phone call, letter, or email is a piece of your patient's story. Sometimes, questions or disputes may arise, and documentation is independent evidence that can clarify details, and help avoid future confusion and misunderstandings.

You may print just a few, as needed, or take the artwork to your local print shop for quantity printing and drilling of holes on top of page.


$49.50 $30.78

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.


$40.50 $26.00

This release form is used to obtain client photography and interview permission and includes rules by which patient/client must agree to abide in exchange of value received to client/doctor. Protect yourself if you will be taking photographs and/or will be using any other patient material for any type of purpose, be sure to have your client's permission in writing.

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.


$31.50 $20.00

This release form is used to obtain client authorization to take photographs for use as an aid in patient's treatment. Protect yourself if you will be taking patient photographs, be sure to obtain your client's permission in writing. Form uses industry standard, legal wording section and may be fully edited or modified using Microsoft Word or other word processors.

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

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.


$31.50 $28.35

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.


$31.50 $20.25

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.

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.


$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.


$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.