Basic Botox Information and Consent Form

Form Template

The Basic Botox Information and Consent Form Mobile App allows a practice that performs Botox procedures to provide information on Botox treatments.

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The information provided in this form template includes what Botox is, how it works, side effects, limitations and the Botox cosmetic procedure details. Your Botox treatment practice can easily customize the content of this information and consent app for treatments, where prior authorization is standard. Capture a person’s signature for consent for the procedure, that confirms their understanding of the effects of Botox on the skin and facial muscles. Make sure patients understand the potential risk for allergic reaction to skin when using the injection to treat lines and wrinkles.

As a practitioner who performs Botox injections at a clinic, use this app to help protect both the practice and the patient for cosmetic skin treatments, like the non-surgical cosmetic injection, that reduce the appearance of frown lines and wrinkles at the injection site. For example, provide comprehensive information to a patient, obtain consent, and protect health before a patient undergoes juvederm ultra or restylane juvederm injections.

Use this app's reporting feature to run convenient report PDFs, exportable and shareable in real time.

  • Signature Capture
  • Submission Editing
  • Reference Data
  • Dispatch
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  • iPhone
  • iPad
  • Android
  • Windows
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  • Salesforce
  • Google Docs
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