Cosmetic Aesthetic Questionnaire

Form Template

This Cosmetic Aesthetic Questionnaire asks about additional services, includes warnings on BOTOX® Cosmetic (onabotulinumtoxinA), LATISSE® (bimatoprost ophthalmic solution) 0.03%, and JUVÉDERM® XC.

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Additional services include: Skin care products such as SkinMedica®*, Facial fine lines/wrinkles, Crow’s feet area, Frown lines area, Length/fullness of eyelashes, Facial fullness/drooping, Chemical peel, Facial veins, Facial redness, Brown spots/age spots/freckles, Drooping brow, Drooping eyelids, Nose size or shape, Mole removal, Scar revision, Blotchy skin, Breast size, Abdominal area, Facial contouring, Body contouring, and Unwanted hair. This application can be accessed anywhere from your smartphone or tablet.

  • Submission Editing
  • Reference Data
  • Dispatch
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  • iPhone
  • iPad
  • Android
  • Windows
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  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
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*The Capterra SoftwareAdvice ​and GetApp logos are a service mark of Gartner, Inc. and/or its affiliates and is used herein with permission.*

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