Policies and Consents Available from DCCM

As our training facility continues to grow, Tara is excited to continue to expand her experience and hard work with you all.

We now offer our Standard Administration Policies, Consents, Patient Instructions and all of your employment form needs. We have done the leg work and we are happy to decrease your work load as you get up and running with your new business. I understand that as you embark on this new adventure there is so much to worry about. Take one stress away and focus on what you are best at…Patient Care. Our entire package of forms is available in digital format. All you need to do is insert your logo and your business name in the language. Our forms have been reviewed by our legal team.

The entire package is priced at $1500.  Individual policies are $100, and all other forms are $50 a piece.  If you follow the link below you can purchase individually or the entire package.

Purchase Policies Package

Table of Contents

Policy for Standard Administration

Within each Standard 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

Policy for Standard Administration List

  • B12
  • CO2
    • Facial/Body
    • Vaginal
  • Dermal Filler
    • Hyaluronic Acid Insertion
    • Occlussion
  • Dermaplane
  • Elos Plus System
    • DSL Motif
    • IPL/SRA/SR
    • LV/LVA
    • Sublative RF
    • Sublime
  • Kybella
  • Microneedle/Collagen Induction Therapy
  • Nutrient Therapy
  • Platlet Rich Plasma
    • Face/tear Troughs
    • Hair
    • Vaginal
  • Profound Radio Frequency
  • Sclerotherapy
  • Zo Chemical Peels

Treatment Consents

What you can expect in each consent:

  • About the Procedure
  • Contraindications
  • Limitations
  • Pregnancy, Neurological, Allergies
  • Pre/Post Care
  • Photographs
  • Payment
  • Results
  • Consent to treatment
  • Additional signature page to have the client resign every time they are treated
    1. B12
    2. CO2
      1. Facial/Body
      2. Vaginal
    3. Dermal Filler
    4. Dermaplane
      1. Elos Plus System
      2. DSL Motif
      3. IPL/SRA/SR
      4. LV/LVA
      5. Sublative RF
      6. Sublime
    5. Hydrafacial
    6. Kybella
    7. Local Anesthesia
    8. Microneedle/Collagen Induction Therapy
    9. Nitrous Oxide
    10. Nutrient Therapy
    11. Platlet Rich Plasma
      1. Face/tear Troughs
      2. Hair
      3. Vaginal
    12. Profound Radio Frequency
    13. Sclerotherapy
    14. Zo Chemical Peels

Pre and Post Care Sheets

  1. B12
  2. CO2
    1. Facial/Body
    2. Vaginal
  3. Dermal Filler
  4. Dermaplane
  5. Elos Plus System
    1. DSL Motif
    2. IPL/SRA/SR
    3. LV/LVA
    4. Sublative RF
    5. Sublime
  6. Kybella
  7. Microneedle/Collagen Induction Therapy
  8. Nutrient Therapy
  9. Platlet Rich Plasma
    1. Face/tear Troughs
    2. Hair
    3. Vaginal
  10. Profound Radio Frequency
  11. Sclerotherapy
  12. Zo Chemical Peels

Supply Lists

Treatment Supply Lists

  • B12
  • CO2
  • Dermal Filler
  • Dermaplane
  • Kybella
  • Microneedle/Collagen Induction Therapy
  • Nutrient Therapy
  • Neurotoxin
  • Platlet Rich Plasma
  • Profound Radio Frequency
  • Sclerotherapy
  • Zo Chemical Peels

Employee Forms

  • Blood Born Pathogen Policy
  • Data Breech
  • Employee Handbook
  • HIPPA
  • I9
  • Job Application
  • Privacy Policy
  • W2

Intake Forms

  • Refund Policy
  • Photo Consent
  • Membership Contract
  • Fitzpatrick Scale
  • HIPPA

User Manuals

  • Core
  • Elos Plus
  • Profound RF
  • Nitrous Oxide

Purchase Policies Package


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We're happy to answer any questions you may have, feel free to call us at
(603) 783-1087