Treatment Plan Agreement
Treatment Plan Agreement — patient-facing form with required fields, disclosures, and signature capture.
- 7 days free
- Cancel any time
- 10 languages
- No patient data stored on our servers
- Fields
- 10
- Practice type
- Med Spa
- Category
- Legal & Compliance
- Languages
- English
- Editable
- Yes — add, remove and reword fields
- Sharing
- Print, PDF or a secure link
Treatment Plan Agreement — preview
Sample layout generated from the actual template.
This Treatment Plan Agreement explains your rights and the office's obligations. Please read carefully before signing.
Free to start — your edits are saved as you go.
About this form
The treatment plan agreement is a legal & compliance document used by med spa practices. Treatment Plan Agreement — patient-facing form with required fields, disclosures, and signature capture. In BoomCloud Forms it is a starting point: every field, heading and statement can be edited before you share it with patients.
Practices may use this template as a starting point and should review the wording against their own professional, regulatory and legal requirements before use.
What's included
This template ships with 10 fields:
- Patient Name — Text
- Date of Birth — Date
- Phone Number — Text
- Specific Authorization / Acknowledgment Details — Long answer
- Effective Date — Date
- Expiration Date (if applicable) — Date
- I have read, understood, and agree to the terms above — Multiple choice
- Signature — Signature
- Date — Date
When practices use it
Med Spa teams typically attach this form to the records and compliance workflow, keeping a signed copy in the patient file. It can be sent digitally ahead of the visit, completed on a tablet in the office, or printed as a PDF.
How to customize it
- Reword any question, add fields, or remove ones your practice doesn't need.
- Apply your practice name, logo and colors so the form matches your brand.
- Switch to another supported language where a translated version exists.
- Share a secure link with the patient, or download a print-ready PDF.