Injectors 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 $1,500. Don’t need the whole package? Individual policies are available for $100 each and any other form is $50 each.

Complete Injectors 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

  1. B12
  2. CO2
    • Facial/Body
    • Vaginal

3.  Coolsculpting

4.  Dermal Filler 

    • Hyaluronic Acid Insertion Occlusion

5.   Dermaplane

6.   Elos Plus System

    • DSL Motif
    • IPL/SRA/SR
    • LV/LVA
    • Sublative RF
    • Sublime

7.   Kybella

8.   Local Anesthesia

9.    Microneedle/Collagen Induction Therapy

10. Neurotoxin

11. Nutrient Therapy (Myers Cocktail)

12.  Collagen Induction Therapy (Collagen Induction Therapy)

    • Face/tear Troughs
    • Hair
    • Vaginal

13.  Profound Radio Frequency

14.  Sclerotherapy

15.  Zo Chemical Peel

Treatment Consents

What you can you 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 patient  resign every time they are treated

Consent List 

  1. B12
  2. CO2
    • Facial/Body
    • Vaginal

3.   Coolsculpting 

4.   Dermal Filler

5.   Dermaplane

6.   Elos Plus System

    • DSL Motif
    • IPL/SRA/SR
    • LV/LVA
    • Sublative RF
    • Sublime

7.   Hydrafacial

8.   Kybella

9.   Local Anesthesia

10. Microneedle/Collagen Induction Therapy

11. Nitrous Oxide (PRO_NOX)

12. Neurotoxin

13. Nutrient Therapy (Myers Cocktail)

14. Collagen Induction Therapy (Collagen Induction Therapy)

    • Face/tear Troughs
    • Hair
    • Vaginal

15.  Profound Radio Frequency

16.  Sclerotherapy

17. Skin Growth Removal

18.  Zo Chemical Peels

Pre and Post Care Sheets

1. B12

2. CO2

    • Facial/Body
    • Vaginal

3. Dermal Filler

4. Elos Plus System

    • DSL Motif
    • IPL/SRA/SR
    • LV/LVA
    • Sublative RF
    • Sublime

5. Kybella

6. Microneedle/Collagen Induction Therapy

7. Neurotoxin

8. Nutrient Therapy (Myers Cocktail)

9. Collagen Induction Therapy (Collagen Induction Therapy)

    • Face/tear Troughs
    • Hair
    • Vaginal

10. Profound Radio Frequency

11. Sclerotherapy

12. Skin Growth Removal

13. Zo Chemical Peels

Supply Lists

Treatment Supply Lists

  1. B12
  2. CO2
  3. Dermal Filler
  4. Dermaplane
  5. Kybella
  6. Microneedle/Collagen Induction Therapy
  7. Nutrient Therapy
  8. Neurotoxin
  9. Collagen Induction Therapy
  10. Profound Radio Frequency
  11. Sclerotherapy
  12. Zo Chemical Peels

Employee Forms

  1. Blood Born Pathogen Policy
  2. Data Breech
  3. Employee Handbook
  4. Esthetician Compensation Contract
  5. I9
  6. Job Application
  7. W4
  8. Privacy Policy

Intake Forms

  1. Cosmetic Medical Intake
  2. Medical Intake
  3. Cancelation/Refund Policy
  4. Photo Consent
  5. Membership Contract
  6. Fitzpatrick Scale
  7. HIPPA (privacy Policy)
  8. Therapeutic Cannabis Consent
  9. Release of Record
  10. Medical Letter Template

User Manuals

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

SCHEDULE A CONSULTATION IN THE SEACOAST REGION

At Delle Chiaie Cosmetic Medicine in Hampton NH on the Seacoast, we treat all kinds of complexions and conditions. The benefit of being treated at Delle Chiaie Cosmetic Medicine is you don’t just get a Surface treatment: you get the benefit of an experienced and highly trained provider with nearly 20 years in medicine. We can evaluate you both internally and externally. You may be surprised to know that a majority of skin disorders arise from a much more complex internal source. To get started, give us a call at (603) 783-1087. Stay tuned to hear about one of our amazing success stories…


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We're happy to answer any questions you may have, feel free to call us at
(603) 874-4541