Aesthetics - New Patient Intake Form - Integrated Health Clinic 2025

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The document is a Medical Aesthetics Questionnaire and Consent form designed for patients seeking injectable aesthetic procedures. It collects personal information, medical history, previous treatments, skin concerns, and current skincare products. The form also outlines conditions that disqualify patients from treatment, potential side effects of cosmetic procedures like Botox and dermal fillers, and emphasizes the importance of patient consent and understanding of the risks involved.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is clinic intake?

Patient intake is the process through which healthcare organizations collect demographic, social and clinical data, consent forms, insurance, payments and other key pieces of information from new and returning patients prior to their visit.

What is a new patient intake form?

Patient intake forms furnish essential information demographics, history of present illness, medical history, etc. to give the physician a well-rounded picture of the patients health so they can provide the best diagnosis and treatment.

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