Cosmetic Dermatology Consultation Form
What a cosmetic dermatology consultation form asks, with sample questions for cosmetic dermatology practices.
The cosmetic dermatology consultation form on this page records a new patient's concerns, past cosmetic treatments, skin and health history, and medications before a consultation. It's also called a patient information and medical history form.
Cosmetic dermatology consultation form, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on a cosmetic dermatology consultation form in the patient's own language, strictly following the practice's instructions.
- Intake before the visit. Patients answer online before they arrive, or at a kiosk when they check in.
- Answers ready for the clinician. Clinicians see what the patient said before the visit starts.
- Less workload at the front desk. Staff spend less time handing out forms and entering answers by hand.
- Key details at a glance. The care team sees what matters up front and decides who needs attention first.
The form becomes a natural conversation: patients answer by talking, in their own words. AI Doctor is an information and patient-assistance interface. It collects answers for the care team to review. It doesn't diagnose, triage, or give treatment advice.
Sample cosmetic dermatology consultation form questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- Which skin concerns would you like to discuss?Concerns
- Which treatments are you interested in?Concerns
- Have you ever had dermal filler injections?Past treatments
- Have you ever had laser hair removal?Past treatments
- Which skin type best describes you?Skin history
- Do you form thick or raised scars?Skin history
- Have you or a family member had skin cancer?Skin cancer
- When was your last full-body skin check?Skin cancer
- Have you ever taken isotretinoin?Medications
- Do you take any blood-thinning medications?Medications
- Are you pregnant or trying to become pregnant?Pregnancy
- Are you breastfeeding?Pregnancy
These are examples to read, not a form to fill in.
Cosmetic dermatology consultation form: FAQ
What does a cosmetic dermatology consultation form ask?
The sample questions on this page are based on intake forms from Cosmetic Laser Dermatology and A E Skin, a medical spa. This page groups them into six areas: concerns, past treatments, skin history, skin cancer, medications, and pregnancy.
Who fills in a cosmetic dermatology consultation form?
The patient, before the consultation. A E Skin's form asks a parent to sign for patients under 18. Cosmetic Laser Dermatology's form has a line for a parent or legal guardian of a minor.
Why does the form ask about budget and recovery time?
A E Skin's aesthetic questionnaire asks how much time off the patient can take for recovery and how much they would like to invest. The practice's team reviews the answers before the consultation.
Is it the same as a patient information and medical history form?
It can be. A E Skin uses that title for its form, which adds an aesthetic questionnaire on concerns, past treatments, and goals.
Does the form ask about medical skin concerns too?
It can. Cosmetic Laser Dermatology's form adds a medical dermatology section. It asks about the last full-body skin check, skin cancer history, and concerns such as acne, eczema, or rosacea.
Is there a cosmetic dermatology consultation form template?
The sample questions on this page show a typical set. Both forms named above also include the practice's own payment and cancellation policies.
Does AI Doctor give medical advice?
No. It collects information for the care team. It doesn't diagnose, triage, or recommend treatment.
Can patient answers stay on our own servers?
Yes. RAVATAR offers on-prem deployment: the platform can run inside your own perimeter, so patient answers stay there. RAVATAR complies with GDPR and the EU AI Act.
Set up your AI Doctor in Genesis AI Avatar Studio
Genesis AI Avatar Studio is where you set up, test, and publish AI avatars for your website, mobile app, or Holobox. No coding or technical skills needed.
- 01Choose the AI Doctor avatar.
- 02Add your practice's FAQs and visit information.
- 03Talk to it, then publish it.
