Plastic Surgery Intake form

This form will help you collect all the general information about the patient before they undergo any plastic surgery procedure. It contains all the necessary questions and information that will prevent possible complications with the patient during and after the surgery.

Aside from helping the professional learn about the patient through their surgical and medical history, this form will also let the latter understand how the plastic surgery process works and what the possible results are.

Using the patient intake form on this application, you can collect details such as patient name, address, birth date, marital status, emergency contacts, insurance, and other necessary information. In the next section, you can collect surgical and medical information of the patient.

The form also comes with a statement of financial responsibility that will authorize the doctor to bill the patient’s insurance company or any third party responsible for the medical charges.The process for signing the statement has also been made easier as the patient can sign it with their e-signature within seconds, eliminating the need to sign a physical copy after printing it. Patient pictures can also be collected to help the doctors understand their case better using the document collection feature on this application.

It is time to modernize and simplify the patient intake form to provide a better experience to your patients.