|
Votiva consent signed
|
|
|
Procedure Report
|
|
|
Treatment Area
|
Handpiece / Tip Size
|
|
Energy Settings
|
Total Time
|
|
Total Energy
|
|
|
Symptoms / notes
|
|
|
Patient Education
|
|
|
Aftercare Instructions
|
|
|
Provider
|
|
|
Provider Clearance:
|
MA / Esty/Assistant (Charted by)
|
