The Complete Compliance Package for Injectors

Injectors Compliance Package

DCCM™ Academy is a premier way to jumpstart your new injectables business and clientele. We offer a Complete Injectors Package that includes the Standard Administration Policies, Consents, Patient Instructions, and all your employment form needs- taking the leg work out of getting clients in your door and treated. All of our forms have been reviewed by our legal team to ensure the most accurate and effective formatting. By providing the template, all you have to do is add in your logo and business name giving you a head start to injectables success! We understand that this new adventure has many hoops to jump through- let us take some of that stress away so you can worry about what really matters….patient care. Our entire package of forms is provided digitally for ease and is available in its entirety for $1,600. Don’t need the whole package? Individual policies are available for $150 each and any other form is $100-&50 each.

Purchase Policies Package

Complete Compliance Package Table of Contents

Table of Contents for Complete Compliance Package

 

What Is Included? 

• Adverse Event Management Flowcharts 

1. 1. 1. Acute Infection Biofilm 
      2. Antibody Mediated Edema
      3. Herpes
      4. Inflammatory Nodule 
      5. Intravascular Incident (VO)
      6. Kybella Intravascular Accident 
      7. Non-Inflammatory Nodule 
      8. Retinal Occlusion

• B12 

1. 1. 1. Policy for Standard Administration
      2. Patient Consent 
      3. Supply List
      4. Pre/Post Care

• CO2 (Facial, Body, and Vaginal)

1. 1. 1. Policy for Standard Administration (Facial/Body and Vaginal)
      2. Patient Consent 
      3. Supply List
      4. Pre/Post Care

• CoolSculpting 

1. 1. 1. Patient Consent 
      2. Photo Consent
      3. Treatment Sheet
      4. Pre/Post Care

• Cryotherapy

1. 1. 1. Patient Consent 
      2. Pre/Post Care

• Dermal Filler 

1. 1. 1. Policy for Standard Administration 
      2. Patient Consent
      3. Supply List
      4. Pre/Post Care
      5. Biofilm Management Decision Tree
      6. Herpes Management Decision Tree

• Dermaplane 

1. 1. 1. Policy for Standard Administration
      2. Patient Consent 
      3. Supply List

• Elos Plus System (DSL Motif, PL/SRA/SR, LV/LVA, Sublative RF, Sublime) 

1. 1. 1. Policy for Standard Administration
      2. Patient Consent 
      3. Treatment Sheet
      4. Patient Laser History
      5. Pre/Post Care

• Employee Paperwork

1. 1. 1. Employee Handbook 
      2. Job Application 
      3. Job Descriptions
      4. Employment Agreement
      5. I9
      6. W2

• Hydrafacial

1. 1. 1. Patient Consent 
      2. User Manual

• Kybella 

1. 1. 1. Policy for Standard Administration
      2. Patient Consent 
      3. Supply List
      4. Pre/Post Care
      5. Flowchart for Intravascular Accident Management with Kybella

• Local Anesthesia 

1. 1. 1. Policy for Standard Administration
      2. Patient Consent 
      3. Supply List
      4. Pre/Post Care

• Microneedling/Collagen Induction Therapy

1. 1. 1. Policy for Standard Administration
      2. Patient Consent 
      3. Supply List
      4. Pre/Post Care

• Neurotoxin

1. 1. 1. Policy for Standard Administration
      2. Patient Consent 
      3. Supply List
      4. Pre/Post Care 
      5. Herpes Management Decision Tree
      6. Biofilm Management Decision Tree

• Nordlys

1. 1. 1. Fraxel Patient Consent
      2. IPL Patient Consent
      3. Laser Medical History 
      4. Nordlys Treatment Guidelines
      5. Nordlys User Manual 
      6. Eyewear Table

• Nutrient Therapy (IV Therapy, Myers Cocktail) 

1. 1. 1. Policy for Standard Administration
      2. Patient Consent 
      3. Supply List
      4. Pre/Post Care

• Patient Forms

1. 1. 1. Aesthetic New Patient History
      2. Aesthetic Wishlist
      3. Cancellation/Refund Policy 
      4. Fitzpatrick Skin Scale 
      5. Medical Letter Template
      6. Membership Contract
      7. HIPAA Privacy Policy 
      8. Photo Consent
      9. Release of Records

• Pronox

1. 1. 1. Patient Consent
      2. Treatment Manual

• Radio Frequency Microneedling (Profound)

1. 1. 1. Policy for Standard Administration
      2. Patient Consent 
      3. Supply List
      4. Pre/Post Care
      5. Profound In-Service Instructions 
      6. Profound User Manual 
      7. Profound Treatment Record 
      8. Toxic Dose Calculator 

• Collagen Induction Therapy (Collagen Induction Therapy/ Growth Factor Rejuvenation) for Face, Hair, Vaginal 

1. 1. 1. Patient Consent (Collagen Induction Therapy and Collagen Induction Therapy Facelift)
      2. Pre/post Care (Collagen Induction Therapy and Collagen Induction Therapy Facelift)
      3. Admin Policy 
      4. Supply List 

• Quality Assurance

1. 1. 1. Quality Assurance Checklist

• Sclerotherapy

1. 1. 1. Treatment Sheet
      2. Policy for Standard Administration
      3. Patient Consent 
      4. Supply List
      5. Pre/Post Care

•  Sculptra

1. 1. 1. Treatment Sheet
      2. Policy for Standard Administration
      3. Patient Consent 
      4. Supply List
      5. Pre/Post Care

•  Semaglutide (Wegovy)

1. 1. 1. Policy for Standard Administration
      2. Patient Consent 
      3. Compounding Pharmacy Vendor Information
      4. Monthly Membership Contract for Clients
      5. Medical History Intake Form for Primary Consultation

•  Skin Growth Removal + Subcision

1. 1. 1. Pre/Post Care for Skin Growth Removal
      2. Patient Consent (Skin Growth Removal + Subcision)

• Standard Operating Policies

1. 1. 1. Acute or Infectious Communicable Diseases
      2. Adverse Consequences and Medication-Related Problems
      3. Allergic Reaction
      4. Autoclave Sterilization
      5. Bloodborne Pathogens Occupational Exposure
      6. Bomb Threat Procedure
      7. Chemical Inventory
      8. Contaminated Needlestick HIV/HIB Awareness
      9. Controlled Substances
      10. Discarding and Destroying Medications
      11. Disposal of Blades, Glass, Needles, Sharps, and Syringes
      12. Drug Recalls
      13. Earthquake Safety Procedure
      14. Emergency Procedure/Transfer Protocol
      15. Fire Safety Procedure
      16. Germicides Used In Facility
      17. Hand Wash Hygiene
      18. Handling of Biohazard Wastes
      19. Identifying and Managing Medication Errors and Adverse Consequences
      20. Incident Reports
      21. Infection Control Introduction
      22. Infection Control Program
      23. Infection Log
      24. Infectious Disease Program
      25. Injection Technique
      26. Labeling of Medication Containers
      27. Linen
      28. Medication Administration
      29. Medication Charting
      30. Medication Storage
      31. Patient Transfer Form
      32. Record Keeping
      33. Security
      34. Sharps Injury Policies
      35. Spor-Test or Attest
      36. Sterile Packs
      37. Substance Abuse
      38. Traffic Control
      39. Treatment Rooms
      40. Universal Precautions Policy
      41. Wound Infections

• User Manuals Included For: 

1. 1. 1. Core
      2. Elos Plus
      3. Hydrafacial
      4. Profound RF
      5. Nitrous Oxide 

• Vascular Occlusion

1. 1. 1. Vascular Occlusion Policy 
      2. Hyaluronidase (Hylenex) Patient Consent 
      3. Vascular Occlusion Adverse Event Decision Tree 
      4. Retinal Occlusion Adverse Event Decision Tree 
      5. Tara’s Complete Doctoral Dissertation regarding Vascular Occlusion

•  Zo Skincare Protocols and Chemical Peels

1. 1. 3 Step Peel Consent 
   2. Zo Chemical Peel Policy for Standard Administration
   3. Supply List
   4. Pre/Post care

Within each Standard Administration 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 

 

Within each Treatment Consent is the following key items: 

– About the Procedure 

– Contraindications 

– Limitations 

– Pregnancy, Neurological, Allergies 

– Pre/Post Care 

– Photographs 

– Payment 

– Results 

– Consent to treatment 

– Additional signature page to have the patient resign every time they are treated