Forms for use in cosmetic practice centers, centers for cosmetic surgery, plastic surgeons, healthcare, medical offices.
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.
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.
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.
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.
This form functions as a Prescription and Letter of Medical Verbal Orders for healthcare equipment, medications and special orders. Form also records doctor and patient information.
A medical release form is a document that gives healthcare professionals permission to share patient medical information with other parties. Patient's must first sign a release.
According to the U.S. Department of Health and Human Services, “An authorization is a detailed document that gives covered entities permission to use protected health information for specified purposes, which are generally other than treatment, payment, or health care operations, or to disclose protected health information to a third party specified by the individual.”
Did You Know? Verbal medical release agreements are not sufficient because they are impossible to verify if there’s ever a disagreement. Healthcare staff need a written copy on record with a signature to protect themselves. If you are ever instructed to share healthcare information on behalf of a patient, make sure you have them sign a release form.
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.
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
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.
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.
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.