Plastic Surgery Consultation Checklist: A Decision Record

A plastic surgery consultation checklist is most useful when it records your goals, relevant history, the clinician’s explanation of available options and the questions still unanswered. A row with a check mark should mean you captured a clear answer, not that surgery is suitable, safe or agreed. Bring the record to the consultation, revise it with the team and keep the next action beside every unresolved issue. This original worksheet helps you distinguish what you want, what was actually explained and what you still need to understand before deciding.

Download the consultation checklist (printable PDF). Complete it privately and bring unresolved care questions to your treating team.

What does a plastic surgery consultation checklist need to accomplish?

Start with a task you can explain in everyday language. “I want to understand what could address this concern” leaves room for an examination and discussion. “I need this exact operation because an online photograph looks right” begins with an assumption that might not fit your circumstances. The worksheet does not choose the operation. It gives the clinician an organized account of what matters to you and gives you a place to capture the reasoning behind any recommendation.

Use separate lines for a desired change and its practical consequences. An appearance concern, discomfort, clothing problem and work limitation may relate to the same area, but they are different goals. Tell the clinician which concerns are yours and which came from other people’s comments. You do not need to prove a concern is important enough to mention. You do need an honest conversation about what an intervention can and cannot reasonably address, including whether a surgical approach makes sense at all.

The American Society of Plastic Surgeons publishes a consultation questionnaire covering candidacy, technique, setting, recovery help, complications and reasonable expectations. Its questions are prompts for discussion, not proof that a clinician or facility meets a particular standard. This guide builds an original answer record around those categories rather than copying the organization’s checklist. ¹

Build the first page of your plastic surgery consultation checklist

Prepare a short front page that someone can understand without scrolling through a long message history. State the concern in your words, the main reason for seeking advice and your priorities. Add relevant past treatment or surgery and where records can be obtained. Keep a longer history available for the team rather than leaving out information because the front page is short. The practice may have its own intake form; this record supplements that form and does not replace its medical questions.

Record area	What you can prepare	What the clinician needs to explain
Concern and goal	Your own description and the change you hope to understand	Whether the proposed approach addresses that goal and its limits
Relevant history	Known diagnoses, prior operations and available records	Which facts change the assessment or require further information
Medicines and exposures	Actual current products, doses if known and use patterns	What needs review; do not create your own stop or restart instructions
Practical constraints	Work, dependents, access, travel and help questions	Which constraints affect planning and which decisions remain open
Options and next action	A place for each alternative and unresolved question	Reasoning, uncertainties and the person responsible for the next answer

Bring an actual medicine list rather than relying on memory. Include prescribed medicines, nonprescription products and supplements, and report relevant nicotine, alcohol or other substance use candidly when the team asks. If you do not know a product’s name or dose, say that it needs confirmation and bring the packaging or a clear record through the practice’s approved channel. The purpose is accurate disclosure. Nothing in a plastic surgery consultation checklist tells you to stop, change or conceal a medicine.

AHRQ’s visit-preparation guidance recommends thinking through questions, bringing a medicine list and considering a trusted person who can help with questions and notes. The page is general communication education reviewed in November 2020, not a current plastic surgery regimen. Use that limited advice to prepare the conversation, then obtain any procedure-specific instructions from the actual treating team. ³

Separate a goal from a proposed technique

Make the goal column understandable without naming an operation. For example, a fictional reader might write “understand whether anything can change a visible contour concern” rather than assuming that an implant, removal or transfer is the answer. The clinician may identify a different issue, describe several approaches or explain why an intervention is unlikely to achieve the desired change. Record that explanation in the options column. Do not quietly change the goal to make it match a procedure already selected from advertising. The before-and-after photo interpretation guide helps frame a specific question about the example being shown.

Photographs can help illustrate what you mean, but they do not establish that another person’s anatomy, procedure or outcome is comparable. Ask what part of an example is realistic in your situation and what part is not. Record an explanation about limitations in words alongside any image. If a photograph becomes the only reference point, it is easy to leave the visit with a shared-looking image but different assumptions about scars, symmetry, function or the magnitude of change being discussed.

Treat “do nothing now,” obtaining more information and revisiting the decision as possible discussion paths when appropriate. They are not automatically medically suitable alternatives; the clinician must explain the context. AHRQ’s SHARE framework describes a clinician-led discussion of options, benefits, harms and what matters to the patient. The current overview was reviewed in February 2026. It supports meaningful dialogue, not a guarantee that this worksheet is a validated decision aid or that every option applies to every reader. ²

Capture the answer, its meaning and its source

Use your plastic surgery consultation checklist to record enough detail that you can explain the answer later. “Risks discussed” is a weak entry because it does not say which risks, how they apply or what you understood. A better planning entry identifies the issue discussed, the clinician’s explanation and a question you still have. You are documenting your understanding, not transcribing a medical record or independently interpreting a risk estimate. Ask the team to correct your summary where needed.

Question record	Example of an incomplete entry	More useful record structure
Expected change	“Good result expected”	What change was described, what cannot be promised and what remains uncertain
Technique	“Recommended method”	Proposed approach, reason given and alternative that needs discussion
Recovery planning	“Time off explained”	Actual task restrictions or planning questions and where written instructions will come from
Complication handling	“Office available”	Confirmed contact route, after-hours arrangement and unresolved local-care question
Decision status	“Consultation completed”	Information received, open questions and next step; no implied consent

Keep a source beside a statement when that source changes its meaning. An estimate you remembered, a written practice document and a clinician’s individualized explanation are not interchangeable. Put the document’s title or date next to a contractual or preparation question, and identify which team member provided an answer when appropriate. You do not need a recording to make a useful record. If you want to record a conversation, ask permission and confirm applicable practice rules before doing so.

Avoid converting uncertainty into certainty as you clean up your notes. If the clinician said a question depends on an examination, further history or another professional’s assessment, retain that condition. If you cannot remember the answer accurately, mark it for clarification rather than filling the blank with an internet summary. The quality of a plastic surgery consultation checklist comes from preserving meaningful distinctions, including the distinction between something discussed and something resolved.

An original plastic surgery consultation checklist example

Consider a fictional reader who prepares six questions for a visit. Four receive explanations the reader can summarize. One depends on obtaining a previous operative report, and one needs a separate written fee or policy response. The arithmetic is six questions minus four presently understood explanations equals two open items. Those counts are invented only to show how the record works. Four answered questions do not establish candidacy, adequate consent, clinical completeness or a reason to book surgery.

The missing operative report and missing policy answer should not be collapsed into the same next step. The first item needs an actual record source, release process and clinician review. The second needs the relevant written document and an explanation of its terms. Assign each item a responsible role and a confirmation method. A staff member’s willingness to request a document is useful, but it is different from that document arriving and its contents being reviewed. Keep those stages visible in the record.

Use status words such as “prepared,” “discussed,” “needs clarification” and “confirmed in writing.” Do not use a green score or a percentage of completed boxes to represent readiness. A single unresolved issue might materially change the proposed plan, while several unanswered administrative details might be easy to resolve separately. Your plastic surgery consultation checklist should preserve the significance of each question rather than treating all rows as equal points in a decision game.

Which consultation questions deserve a separate follow-up?

Some questions concern the clinician’s recommendation; others concern scheduling, billing, facility arrangements or records. Ask who is responsible for each answer. A coordinator can explain how a practice communicates without supplying a medical assessment. A clinician can explain a procedure without knowing the final insurer determination or the exact cancellation terms. Directing a question to the right role can make the follow-up more efficient while keeping the medical decision and the commercial transaction distinguishable. Use the second opinion preparation record if the unresolved question calls for another consultation.

If an answer changes, retain the earlier context instead of silently overwriting it. Write what changed, who explained the change and whether other arrangements need to be revisited. For example, a revised proposed operation might change which information you need about recovery help or costs. This is a dependency in the planning record, not an instruction to infer a new recovery duration. The actual team must provide the revised clinical guidance. The record helps prevent an old assumption from remaining hidden in a newer plan.

Separate verification tasks from impressions about the visit. You may feel listened to and still need to check a credential or written term. You may feel rushed and still need an accurate explanation rather than assuming an unfavorable clinical conclusion. The plastic surgery consultation checklist does not rank providers or tell you which person to choose. It gives you a way to identify what evidence or clarification you need before evaluating a recommendation or deciding what further advice would be useful.

Keep clinical questions separate from a proposed purchase

A consultation can include medical explanations and a discussion of payment, but those are different records. Put the proposed intervention and its clinical reasoning in the decision record. Put itemized charges, exclusions, deposits and cancellation terms in the actual written quote or policy record. If the practice offers a promotion, do not let its expiration become a substitute for the time needed to understand the recommendation. Ask how to obtain the remaining information before taking a commercial step that carries obligations. The deposit and refund terms worksheet keeps commercial terms separate from clinical explanations.

This distinction matters when an answer sounds complete but refers to a different question. “The price includes follow-up” does not explain what follow-up is clinically planned, where it occurs or who will assess a new problem. “The operation could address the concern” does not say what the quote includes. Use a plastic surgery consultation checklist entry to identify the unanswered clinical question, and a separate policy entry for the unanswered contractual one. Neither answer should be inferred from the other.

Retain document versions when comparing proposals. A written estimate may describe a different technique or extent from what was discussed at an earlier visit. Ask the team to explain the difference rather than comparing two totals as though they describe identical care. Your record can note that a reconciliation is needed without asserting which proposal is medically preferable or financially fair. The useful next action is to obtain a consistent explanation of what is being proposed and what remains outside that proposal.

Do not turn the worksheet into a public evaluation of a named practice. Keep personal information, preliminary assessments and correspondence private, and use the practice’s approved method to send records. If you later seek another opinion, provide an accurate packet rather than only the excerpts that support your preferred answer. Your plastic surgery consultation checklist should preserve the full context of the question, including uncertainty, a changed recommendation and a decision to wait or seek more information. That makes it a better foundation for the next conversation.

A printable plastic surgery consultation checklist

The printable version is an original blank decision record, not a consent form. Use one row for each question and include the goal or issue, your prepared information, the answer as understood, its source and the next action. Leave enough space for an uncertainty rather than forcing a short yes-or-no response. Keep the worksheet with your own planning records. It contains no instructions to upload personal information publicly or share private photographs with this website.

Before the appointment, circle the few questions that matter most to you so they do not disappear among administrative details. During the discussion, take brief notes and ask for an explanation in ordinary language when needed. Afterward, review the record while the conversation is fresh. Bring unclear entries back to the team, and identify any document you still need. The practical goal is a record that supports another conversation, not a page that looks impressively complete.

Planning stage	Action in the original worksheet	Limit to preserve
Before the visit	State goals, list actual information and prioritize questions	A chosen phrase or image does not establish a diagnosis or suitable procedure
During the visit	Record explanations, uncertainties and the source of answers	Notes are your understanding, not an independently verified clinical assessment
After the visit	Clarify open items and obtain promised documents	A completed appointment is not automatic consent or a booking commitment
When the plan changes	Date the change and revisit dependent questions	Earlier assumptions must not substitute for updated team guidance

Common questions about using the record

Is a plastic surgery consultation checklist a consent document?

No. It is a communication and planning aid. Actual informed consent requires the appropriate substantive discussion and documentation for the proposed care. Keep the worksheet separate from whatever forms or patient decision materials the team supplies. A signature on a planning sheet, a favorable consultation experience or the number of questions answered cannot stand in for an individualized explanation of the intervention, relevant risks, alternatives and remaining uncertainties.

Can a companion use the checklist with me?

You can ask a trusted person to help organize questions and remember explanations if you want their involvement. Agree beforehand about their role and what information you are comfortable sharing. The companion should not replace your preferences with their own. If communication access is needed, discuss appropriate arrangements with the practice rather than assuming that a relative can provide every required interpretation function. The record should reflect your questions and the explanations you understand.

What if I have already decided which procedure I want?

Bring that preference, but also state the underlying goal and ask whether the proposal fits the assessment. Record an explanation that differs from what you expected instead of editing it out. A plastic surgery consultation checklist remains useful precisely when a conversation changes your assumptions. It should help you understand the reasoning and identify the next question, while leaving clinical suitability and the final informed decision to the proper individualized process.

Do I need every box filled before the visit ends?

No. Some questions may require records, further assessment or another conversation. A useful unfinished worksheet identifies those dependencies clearly. Ask how the unresolved items will be addressed and when to expect the next communication, without interpreting an administrative estimate as a clinical deadline. Preserve the distinction between information that has been received, an explanation you understand and a decision you have actually made. That is the central purpose of this record.