Forms for use in cosmetic practice centers, centers for cosmetic surgery, plastic surgeons, healthcare, medical offices.
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.
This form is find out what procedure(s) your client is interested in, it contains a multitude of cosmetic practice therapies and procedures. Easy to respond check boxes so client can just check mark the procedures of interest. If is followed by a few more questions concerning the personal opinions the client may have about the procedure and if they had previous cosmetic surgery. Get informed on what your customers wish for.
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.
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.
This form is used used to obtain new patient medical history. Form is divided into 4 sections. Patient information, past medical history, medications, and the last section is reserved for women only. May be used as is, or easily personalized to your individual needs, using compatible word processor.
A patient's guide and checklist for patients using CPAP and BiPAP medical, therapy equipment.
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.
A list of frequently asked questions about Botox and Botox injections, patient handout / leaflet. Easily editable using word processor.
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.
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.
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.
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.
myMed Kit for Restylane® Practice provides you with 28 (Some forms may contain 2 and 3 pages), state-specific, necessary forms to start your Restylane practice or can be used to replace your old, outdated and faded existing practice forms. Forms have been developed under the direction of cosmetic practice physicians, medical staff, medical attorneys and form developers to provide you with aesthetically designed, legal forms that are pleasing and relaxing to your clients when requesting their signature on legal forms, preventing client confusion and disappointment.
Doctors wanting to immediately add Restylane to their list of services will find myMed Kit for Restylane® an indispensable forms tool kit offering a wide array of forms at minimal expense, saving you valuable time and money. Existing cosmetic practice can do away with old, faded and outdated legal-looking and scarry forms and update their office forms and client and patient perception of your office setting without the added expense of form design and reprint.
Tip: Many physicians overlook the value of having professional office forms that accurately reflects their brand image, many times you see them copy the same forms over and over again until they are hardly visible to read and do reflect a careless image on your work methods, yet this small piece of paper can be an important part of your collateral package. It's often the first item new patients receive from your staff, so it's your first opportunity to make a strong, positive impression on them.