Medium

Available on

Apple Android Windows

Skin Rejuvenation Consultation Form Mobile App

This Skin Rejuvenation Consultation Form mobile app is used by dermatology clinics to capture patient information and consent for skin rejuvenation treatments. Details skin information, areas for skin treatment, and customer expectations. During this initial consultation, you also have the ability to ask the patient about current skin care, sun exposure, fine lines and wrinkles concerns. This app also includes a section for consultant notes to indicate whether the client is suitable for treatment and why or why not.

All information is saved in the GoCanvas Cloud and can be printed or emailed as a PDF if you need to use it as reference during skin rejuvenation treatments. This app can be downloaded to an iPhone, iPad, or Android device.

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

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Take a peek inside the Skin Rejuvenation Consultation Form Mobile App

Included Features

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Included Fields

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

  • Ico textbox

    Client Number

  • Ico textbox

    Client Name

  • Ico date

    Date of Treatment

  • Ico textbox

    Operators Name

  • Ico multiline

    Notes

  • Ico date

    Date

  • Ico statictext

    Skin Type

  • Ico checkbox

    Dry

  • Ico checkbox

    Oily

  • Ico checkbox

    Normal

  • Ico checkbox

    Patchy

  • Ico checkbox

    Sensitive

  • Ico statictext

    Prone to Pigmentation

  • Ico checkbox

    Open Pores

  • Ico checkbox

    Other

  • Ico statictext

    Previous Treatment Methods

  • Ico checkbox

    Electro Surgery

  • Ico checkbox

    Laser

  • Ico checkbox

    Acid Peels

  • Ico checkbox

    MicroDermabrasion

  • Ico checkbox

    Other

  • Ico statictext

    Areas to be treated:

  • Ico checkbox

    Abdomen

  • Ico checkbox

    Armpits

  • Ico checkbox

    Back

  • Ico checkbox

    Bikini

  • Ico checkbox

    Buttocks

  • Ico checkbox

    Cheeks

  • ...and More!

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