Botox Consultation Form
What a Botox consultation form asks, with sample questions on concerns, past injections, and health history.
A Botox consultation form records concerns, past injections, health history, medicines, allergies, and pregnancy before botulinum toxin injections. The questions on this page come from a medical spa's medical history form and a facial plastic surgery practice's client history form. BOTOX is a trademark of Allergan, Inc., an AbbVie company; RAVATAR is not connected to it.
Botulinum toxin consultation form, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on a botulinum toxin 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 botulinum toxin consultation form questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- Are fine lines or deep wrinkles a concern?Concerns
- Which other skin concerns do you have?Concerns
- When was your last injection treatment?Past injections
- Have you had collagen or filler injections?Past injections
- Do you have a neurological disorder?Health history
- Do you have an autoimmune disease?Health history
- Do you take any aminoglycoside antibiotics?Medications
- Do you take blood-thinning medicines?Medications
- Which allergic reactions have you had?Allergies
- Are you allergic to latex?Allergies
- Are you pregnant or breastfeeding?Pregnancy
- Are you trying to become pregnant?Pregnancy
These are examples to read, not a form to fill in.
Botox consultation form: FAQ
What does a Botox consultation form ask?
The sample questions on this page are based on a medical spa's medical history form and a facial plastic surgery practice's client history form. This page groups them into six areas: concerns, past injections, health history, medications, allergies, and pregnancy.
Who fills in a Botox consultation form?
The patient, before the consultation. The medical spa's form asks for a parent's signature for patients under 18.
Does it ask about neurological conditions?
Yes, the medical spa's form lists neurological disorders, myasthenia gravis, Lambert-Eaton syndrome, ALS, and Parkinson's disease among its checkboxes. The practice's team reviews the answers before treatment.
Does it ask about medicines?
Yes. The medical spa's form asks about aminoglycoside antibiotics, blood thinners, and isotretinoin, and asks patients to list every prescription medicine.
Is there a Botox consultation form template?
The sample questions on this page show a typical set, drawn from the two practice forms described above.
What happens after the form is completed?
The injector or another member of the practice's team reads the answers before treatment. AI Doctor only collects them; it does not decide whether injections are suitable.
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.
