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ethereal glow
Aesthetics · Patient Consultation
Patient Notes
Internal — Not PrintedPatient Goals
Treatment PreferencesPatient Concerns
Chief Complaint & GoalsPrimary Concerns
Treatment History
Prior Aesthetic TreatmentsMedical Screening
Clinical Safety Assessment| Screening Item | Response | Notes / Details |
|---|---|---|
| Known allergies (latex, lidocaine, hyaluronidase) | ||
| Current medications (including blood thinners, supplements) | ||
| Pregnancy or breastfeeding | ||
| Autoimmune or neuromuscular disorders | ||
| Active skin infection / cold sores | ||
| Bleeding / clotting disorders | ||
| Prior cosmetic surgery in treatment area | ||
| Permanent filler history |
Facial Assessment
Zones & Clinical ObservationsZone Observations
Clinical Findings
Provider-Facing Summary of FindingsContributing Factors
Personalized Treatment Plan Builder
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Execution LogTreatment Notes
Safety & Technique DocumentationNeurotoxin Documentation
| Area | Product | Units | Notes |
|---|---|---|---|
| Glabella | |||
| Frontalis | |||
| Crow's Feet (L/R) | |||
| DAO / Chin | |||
| Lip Flip / Gummy Smile | |||
| Nose / Bunny Lines | |||
| Masseter (L/R) | |||
| Platysma / Neck |
Total Units: 0
Dermal Filler Documentation
| Area | Product | Syringes | Notes |
|---|---|---|---|
| Temples | |||
| Lips | |||
| Nasolabial Folds | |||
| Cheeks / Midface | |||
| Tear Trough | |||
| Jawline | |||
| Marionette Lines | |||
| Chin / Chin Shadow | |||
| Neck | |||
| Hands |
Total Syringes: 0
Product Details
| Product/Brand | |
| Lot Number | |
| Expiration Date | |
| Dosage | units of neurotoxin reconstituted with mL of bacteriostatic normal saline. |
Product Details
| Product/Brand | |
| Lot Number | |
| Expiration Date |
Click to select phrases, then compile into notes.
Safety
Conservative dosing approach
Avoided high-risk vascular zones
Aspiration performed
Slow injection technique
Hyaluronidase on hand
Anatomy reviewed pre-injection
Technique
Layered technique utilized
Linear threading
Retrograde fanning
Cannula used
Needle used
Bolus technique
Microdroplet technique
Assessment
Symmetry assessed pre/post
Photos taken pre/post
Patient tolerated well
No adverse events
Ice applied post-procedure
Patient verbalized understanding
Post-Treatment
Instructions & Follow-UpSOAP Note
Clinical DocumentationSSubjective
OObjective
AAssessment
PPlan