Forms for use in cosmetic practice centers, centers for cosmetic surgery, plastic surgeons, healthcare, medical offices.
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.
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.
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 New Client Information form can be used to obtain patient information as an intake or registration form. Its contemporary and clean design makes it easy for clients/patients to read and answer the questions. May be used as is, or easily editable using Microsoft Word to assist you in asking only the questions that you wish to obtain from your patients.
Avoid malpractice suits that can tarnish the physician's reputation and raise malpractice insurance premiums by having your client accept binding arbitration of any dispute, avoiding the client's right to a trial. For use in California.
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.
The HIPAA Privacy Rule gives individuals a fundamental new right to be informed of the privacy practices of their health plans and of most of their health care providers, as well as to be informed of their privacy rights with respect to their personal health information. Health plans and covered health care providers are required to develop and distribute a notice that provides a clear explanation of these rights and practices. The notice is intended to focus individuals on privacy issues and concerns, and to prompt them to have discussions with their health plans and health care providers and exercise their rights.
Did You Know? The notice must include an effective date, it is your responsibility to add the effective date. See 45 CFR 164.520(b) for the specific requirements for developing the content of the notice. A covered entity is required to promptly revise and distribute its notice whenever it makes material changes to any of its privacy practices. See 45 CFR 164.520(b)(3), 164.520(c)(1)(i)(C) for health plans, and 164.520(c)(2)(iv) for covered health care providers with direct treatment relationships with individuals.
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.
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.
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.
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.
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.
Botox Therapy Consent Form. Patient authorizes physician to perform Botox injections and is informed of all that is related to the procedures such as the proposed treatment, anticipated benefits, risks and complications associated with treatment, Botox limitations and alternatives, costs/fees, follow ups, photographs, etc. Consent signature is at bottom and patient consents that all above questions have been answered and accepts the risks and complications of the procedure.
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.