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.

$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 $28.35

This is a Restylane® 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 types of surgical procedures, easily edit and change form fields to best meet your needs. May be used as is, or easily personalized using compatible 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 $28.35

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.

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.


$34.20 $22.68

Medical Practice Surgery Cancellation Policy, provides information regarding the physician's surgery scheduling and rescheduling policy. It covers areas for scheduling an in-office procedure, scheduling surgery, rescheduling surgery can cancelling surgery, plus fees associated. Acceptance date and signature lines at bottom of form.


$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.


$18.00 $16.20

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.


$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.


$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.