EyeFACE Institute

Consultation Proposal Generator

Patient Information

Procedures Discussed

Multi-Select · Per-Procedure Pricing · CAD

Check the procedures this patient is a candidate for. Enter the specific quoted price (CAD) for each selected procedure — price input activates when you check the box.

ProcedureSedationDurationRange (Reference)Quoted Price (CAD)
Duration:
Duration:

Bespoke Surgical Elements

Programs, Financing & Surgical Onboarding

Patient interested in financing through Beautifi
Patient consented to receive health information by email (PHIPA)
🔒 Email Proposal button is locked until PHIPA email consent is confirmed above.
Include deposit payment link in patient email
Standard links for $1,500 and $1,800 are built in. Only paste a link here if using a non-standard amount — create at squareup.com/dashboard/checkout-links
Select a deposit amount and check "Include deposit payment link" above.

Clinical Context

Goes on Proposal

Coordinator Notes

Goes on Proposal

Internal Notes

Does Not Go on Proposal

MD Notes

Internal Only — Never Prints on Proposal
5.0 = ideal candidate · 3.0 = threshold · <3.0 = internal red flag

Medical Preparation

Scheduling & Follow-Up

Default: 180 days from consultation
OHIP only — no cosmetic fee
$1,800 CAD standard · $1,500 CAD if booked within 90 days ($300 consult fee credited)
📋

Select procedures and enter a patient name to generate the consultation proposal.