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.
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.
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 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.
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 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 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.
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.
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.
Proper, specific, and reproducible labeling of anatomic locations of dermatologic lesions or therapy is important to record as part of a patient's medical history. These drawings can serve as a list of locations treated (e.g. with Botox, etc.) proving very useful on patient's next visit.
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.
This Planning for Cosmetic Surgery brochure is a great planning toolkit and a helpful resource to answer your patient's general questions and address basic information that may be relevant to their plastic surgery experience. Patient safety should be your highest priority and informing your patients will be your biggest asset. Teaching your patients about their options will help them be educated patients, better prepared for physician consultations and ready to decide on which procedure is right for them.
This is a great brochure and editable using Microsoft Word. Easy to personalize, once completed, print, in your office, as many as needed, or deliver camera-ready artwork to your local speedy printer or print shop, for quantity brochure printing.