Medium

Available on

Apple Android Windows

Informed Consent for Image Treatments Mobile App

Capture patient consent quickly on an iPhone, iPad, or Android mobile device with this Image Treatment Informed Consent mobile app. Use of this app is beneficial for any health care professional who assists patients in the decision-making process in regards to skin care regimens, such as acne, rosacea, and wrinkles.

You can include client information, medical treatment details, precautions, specific treatment plan, consent to treatment, and more. Also includes client signature capture. Each image consent form is saved in your GoCanvas Cloud account and can be shared as a PDF.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

Want to learn more about GoCanvas?

Request a Demo

Take a peek inside the Informed Consent for Image Treatments Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

  • {{data.title}}

Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico date

    Date

  • Ico textbox

    Name

  • Ico textbox

    Address

  • Ico textbox

    City/State/Zip

  • Ico textbox

    Home Phone

  • Ico textbox

    Work Phone

  • Ico textbox

    Cell

  • Ico textbox

    Email

  • Ico textbox

    Fax

  • Ico statictext

    (Please initial by each statement)

  • Ico textbox

    The treatement was explained to me in detail.

  • Ico textbox

    The benefits of what I can realistically expect to see from my Clinical Peel have been fully expl...

  • Ico dropdown

    Treatment

  • Ico statictext

    SKIN CONDITION (Please select all that apply)

  • Ico checkbox

    SUPERFICIAL WRINKLES, FINE LINES

  • Ico checkbox

    DEEP WRINKLES, FINE LINES

  • Ico checkbox

    ACNE OR ACNE PRONE

  • Ico checkbox

    DEEP HYPERPIGMENTATION (SUN OR BROWN SPOTS)

  • Ico checkbox

    SEVERE PHOTOAGING

  • Ico checkbox

    ROSACEA

  • Ico checkbox

    DEHYDRATION

  • Ico checkbox

    ACNE SCARS

  • Ico checkbox

    UNBALANCED

  • Ico statictext

    (Please Read Carefully)

  • Ico statictext

    The Treatment you will receive is a clinical treatment designed to exfoliate or remove the outer ...

  • Ico statictext

    Your participation in your skin care treatments will determine the outcome.

  • Ico statictext

    No guarantee is expressed or implied as to the precise results, peeling times or discomfort.

  • Ico statictext

    During the treatment, you may experience some temporary stinging or warm flushing.

  • ...and More!

Related Beauty, Massage & Spa Apps... and they're all free for GoCanvas subscribers!

App Name

Radiofrequency Consent Form (Canada)

The Radiofrequency Consent Form (Canada) is a consent template for practices who require a client consent form for radiofr...

App Name

Esthetician Client Consultation Card

The Esthetician Client Consultation Card mobile app helps estheticians, salons, day spas, cosmetology businesses and derma...

App Name

Esthetician Consent Form

The Esthetician Consent Form app provides an easy alternative to filling out lengthy consent paperwork. With this simple a...

App Name

Client Consent for Chemical Peels

This Client Consent for Chemical Peels app quickly captures client consent information on a mobile device. This app pulls ...

App Name

Confidential Intake Form Skin Care Es...

The Confidential Intake Form Skin Care Esthetics (Canada) form is a template containing both a questionnaire and consent f...

App Name

Esthetician Client Consent Form (Canada)

The Esthetician Client Consent Form (Canada) is a simple consent template to be used by estheticians prior to a procedure ...

App Name

Brow / Lash Tinting Consent Form

This Brow / Lash Tinting Consent Form Mobile App electronically captures client consent in a way that is convenient and sa...

App Name

Esthetician Client Profile Card

The Esthetician Client Profile Card Mobile App was developed to replace paper forms with digital forms. The app allows th...

More Information


Recent Blog Posts