Plastic Surgery Consultation Form
What a plastic surgery consultation form asks, with sample questions on procedures of interest, health, and medicines.
A plastic surgery consultation form records contact details, the procedures a patient is interested in, past treatments, health, and medicines before a cosmetic consultation. It's also called a cosmetic surgery consultation form.
Plastic surgery consultation form, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on a plastic surgery 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 plastic surgery consultation form questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- How did you hear about this clinic?Contact details
- May we contact you by email?Contact details
- Which procedures are you interested in today?Procedures
- Which areas would you like to improve?Procedures
- Which cosmetic procedures have you had before?Past treatments
- Did you have surgical or anesthesia complications?Past treatments
- Do you bruise easily?Health history
- Have you had an EKG in the past year?Health history
- Which medicines do you take regularly?Medicines
- Do you take vitamins, herbs, or fish oil?Medicines
- Do you smoke?Lifestyle
- How much alcohol do you drink?Lifestyle
These are examples to read, not a form to fill in.
Plastic surgery consultation form: FAQ
What does a plastic surgery consultation form ask?
The sample questions on this page are based on UT Southwestern's cosmetic surgery clinic application and a facial plastic surgery practice's patient form. This page groups them into six areas: contact details, procedures, past treatments, health history, medicines, and lifestyle.
Who fills in a plastic surgery consultation form, and when?
The patient, before the first consultation. UT Southwestern's application starts with contact preferences, such as whether the clinic may leave messages or send email.
Is it the same as a cosmetic surgery consultation form?
It can be. UT Southwestern's version is called a Cosmetic Surgery Resident Clinic Application, and it opens with a cosmetic interest questionnaire.
Does it ask about future procedures?
Yes. The UT Southwestern form asks patients to mark any procedures they may want in the future, besides the reason for today's visit.
Does it ask which facial areas concern the patient?
Yes. The facial plastic surgery practice's form lists areas such as the eyelids, brow, nose, lips, chin and jaw line, and neck for the patient to mark.
What happens after the plastic surgery consultation form is completed?
The practice's team reviews the answers before the visit. AI Doctor gathers them and leaves every decision about surgery to the surgeon.
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.
