Let Us Help You Build Your Empire...
Every Form You Ever Needed to Run Your
Aesthetics Practice With Confidence and Compliance
This package of customizable forms for your practice goes beyond just patient intake and treatment consent forms. We include every form we use here at Delle Chiaie Cosmetic Medicine from our employee handbook to treatment policies and administration procedures.
Perfect for new aesthetics practices and solo injectors, every form is offered in compatible formats with Pages and Word, and can be customized with your logo and medical director's name. We update these forms constantly based on our own experiences so you can benefit from the observations of a seasoned medical aesthetic practice as well as your own!
Spend your time and energy perfecting your
technique and improving your patient results, not on making sure you are legally covered in case of
complications.
It is not a question of if, but when.
Weather is is a dissatisfied patient or a vascular occlusion, legally complex situations befall even the most experienced of providers. The consequences of these situations can be severe and legally devastating to an injector's practice and reputation. Don't run the risk of loosing everything you worked so hard to achieve by not ensuring you are covered.
Compliance Package Table of Contents
Table of Contents for Complete Compliance Package
What Is Included?
- Adverse Event Management Flowcharts
- Acute Infection Biofilm
- Antibody Mediated Edema
- Herpes
- Inflammatory Nodule
- Intravascular Incident (VO)
- Kybella Intravascular Accident
- Non-Inflammatory Nodule
- Retinal Occlusion
- B12
- Policy for Standard Administration
- Patient Consent
- Supply List
- Pre/Post Care
- CO2 (Facial, Body, and Vaginal)
- Policy for Standard Administration (Facial/Body and Vaginal)
- Patient Consent
- Supply List
- Pre/Post Care
- CoolSculpting
- Patient Consent
- Photo Consent
- Treatment Sheet
- Pre/Post Care
- Cryotherapy
- Patient Consent
- Pre/Post Care
- Dermal Filler
- Policy for Standard Administration
- Patient Consent
- Supply List
- Pre/Post Care
- Biofilm Management Decision Tree
- Herpes Management Decision Tree
- Dermaplane
- Policy for Standard Administration
- Patient Consent
- Supply List
- Elos Plus System (DSL Motif, PL/SRA/SR, LV/LVA, Sublative RF, Sublime)
- Policy for Standard Administration
- Patient Consent
- Treatment Sheet
- Patient Laser History
- Pre/Post Care
- Employee Paperwork
- Employee Handbook
- Job Application
- Job Descriptions
- Employment Agreement
- I9
- W2
- Hydrafacial
- Patient Consent
- User Manual
- Kybella
- Policy for Standard Administration
- Patient Consent
- Supply List
- Pre/Post Care
- Flowchart for Intravascular Accident Management with Kybella
- Local Anesthesia
- Policy for Standard Administration
- Patient Consent
- Supply List
- Pre/Post Care
- Microneedling/Collagen Induction Therapy
- Policy for Standard Administration
- Patient Consent
- Supply List
- Pre/Post Care
- Acute Infection Biofilm Adverse Event Management Decision Tree
- Neurotoxin
- Policy for Standard Administration
- Patient Consent
- Supply List
- Pre/Post Care
- Herpes Management Decision Tree
- Nordlys
- Fraxel Patient Consent
- IPL Patient Consent
- Laser Medical History
- Nordlys Treatment Guidelines
- Nordlys User Manual
- Eyewear Table
- Nutrient Therapy (IV Therapy, Myers Cocktail)
- Policy for Standard Administration
- Patient Consent
- Supply List
- Pre/Post Care
- Patient Forms
- Aesthetic New Patient History
- Aesthetic Wishlist
- Cancellation/Refund Policy
- Fitzpatrick Skin Scale
- Medical Letter Template
- Membership Contract
- HIPPA Privacy Policy
- Photo Consent
- Release of Records
- Pronox
- Patient Consent
- Treatment Manual
- Radio Frequency Microneedling (Profound)
- Policy for Standard Administration
- Patient Consent
- Supply List
- Pre/Post Care
- Profound In-Service Instructions
- Profound User Manual
- Profound Treatment Record
- Toxic Dose Calculator
- Platelet Rich Plasma (PRP/ Growth Factor Rejuvenation) for Face, Hair, Vaginal
- Patient Consent (PRP and PRP Facelift)
- Pre/post Care (PRP and PRP Facelift)
- Admin Policy
- Supply List
- Quality Assurance
- Quality Assurance Checklist
- Sclerotherapy
- Treatment Sheet
- Policy for Standard Administration
- Patient Consent
- Supply List
- Pre/Post Care
- Sculptra
- Treatment Sheet
- Policy for Standard Administration
- Patient Consent
- Supply List
- Pre/Post Care
- Semaglutide (Wegovy)
- Policy for Standard Administration
- Patient Consent
- Compounding Pharmacy Vendor Information
- Monthly Membership Contract for Clients
- Medical History Intake Form for Primary Consultation
- Skin Growth Removal + Subcision
- Pre/Post Care for Skin Growth Removal
- Patient Consent (Skin Growth Removal + Subcision)
- Standard Operating Policies
- Acute or Infectious Communicable Diseases
- Administering Medications
- Adverse Consequences and Medication-Related Problems
- Allergic Reaction
- Autoclave Sterilization
- Bloodborne Pathogens Occupational Exposure
- Bomb Threat Procedure
- Chemical Inventory
- Contaminated Needle Stick HIV/HIB Awareness
- Controlled Substances
- Discarding and Destroying Medications
- Disposal of Blades, Glass, Needles, Sharps, and Syringes
- Drug Recalls
- Earthquake Safety Procedure
- Emergency Procedure/Transfer Protocol
- Fire Safety Procedure
- Germicides Used In Facility
- Hand Scrub Technique
- Handling of Biohazardous Wastes
- Identifying and Managing Medication Errors and Adverse Consequences
- Impaired Healthcare Provider
- Incident Reports
- Infection Control Introduction
- Infection Control Program
- Infection Log
- Infectious Disease Program
- Labeling of Medication Containers
- Linen
- Medication Charting
- Patient Transfer Form
- Performing Injections
- Record Keeping
- Security
- Sharps Injury Policies
- Spor-Test or Attest
- Sterile Packs
- Storage of Medications
- Traffic Control
- Treatment Rooms
- Universal Precautions Policy
- Wound Infections
- User Manuals Included For:
- Core
- Elos Plus
- Hydrafacial
- Profound RF
- Nitrous Oxide
- Vascular Occlusion
- Vascular Occlusion Policy
- Hyaluronidase (Hylenex) Patient Consent
- Vascular Occlusion Adverse Event Decision Tree
- Retinal Occlusion Adverse Event Decision Tree
- Tara's Complete Doctoral Dissertation regarding Vascular Occlusion
- Zo Skincare Protocols and Chemical Peels
- 3 Step Peel Consent
- Zo Chemical Peel Policy for Standard Administration
- Supply List
- Pre/Post care
ZO Skincare ProgramsWithin each Standard Administration Policy is the following key items:
- Purpose
- Setting
- Supervision
- Record Keeping
- Training and Education
- Evaluation and Competency
- Authorized Personnel Documentation
- Limitations
- *System Operation if applicable
- Procedural Steps
- Pre & Post Treatment
- Development of Plan
Within each Treatment Consent is the following key items:
- About the Procedure
- Contraindications
- Limitations
- Pregnancy, Neurological, Allergies
- Pre/Post Care
- Photographs
- Payment
- Results
- Consent to treatment
- Additional signature page to have the patient resign every time they are treated
DCCM™ Practice Owner: Tara Delle Chiaie, MSN, FNP-BC, APRN
Tara has been in medicine since 2002 as a Registered Nurse. In 2011 she graduated from the accelerated program at the University of New Hampshire (UNH) as an Advance Practice Registered Nurse (APRN) and immediately became nationally recognized through the American Nurses Credentialing Center (ANCC) as a Board Certified Nurse Practitioner. She is further Board Certified in Anti-Aging Medicine by the American Academy of Anti-aging Medicine. Growing up in the beauty industry she found it was a great union to blend beauty with medicine. She has an astute sense of safety while her experience guides her practice to produce beautiful and natural results. She has been teaching nursing and medicine for almost 15 years. Sharing her knowledge and helping others define their talent brings her great joy. Tara’s goal is to continually fine tune the art of bringing one's inner beauty to the Surface. This happens by increasing her own education as well as ensuring other health care providers are delivering the same quality of care.
In 2013 Tara opened her Cosmetic business, Delle Chiaie Cosmetic Medicine. Although aesthetics is her passion she found a significant flaw in the health care system and then opened a concierge medical practice; Delle Chiaie Concierge Medicine. Although Tara created her initial business with a strict business plan; she always kept one ear to the ground listening and recognizing the environment around her. This was so she could ensure her organic growth within the industry and being mindful of patient need and economic trends. After seeing several hundreds of clients that needed correction work she quickly realized it was an opportunity to begin teaching others. Creating DCCM Academy was her way to share her experience and knowledge with others while safeguarding patients from the ill informed or the undereducated provider.
Excited for More?
Take advantage of all DCCM™ Academy has to offer and enroll in one of our certification courses for new injectors, book a private training for advanced techniques, or purchase our any of our educational materials to improve your techniques and business practices!
