INTERACTIVE EHR SIMULATOR Operating 100% in-memory from canonical encounter-demo-seed.json.
← Back to Marketing Site

EncounterCF

Configurable Forms: this page is rendered entirely from a JSON configuration (data fields + UI placement, multi-page).

Signed in as uat-harness@esarks.com
Notification
Encounter — Tatiana Rostova (DLP43) Configuration: ReCenter Oasis LLC Encounter v3.1
Patient ID: Y4M0RY · DOB: 1994-09-19 (Age 32) · Sex: F · Date: 09/20/2026 · Type: office_visit
Chief Complaint: Full visit and payment completed · Status: Ready For Checkout
○ Chief complaint documented ✓ Visit type selected ✓ Status progressed from draft ○ Encounter signed
Encounter complete. Open Encounter Work
PROBLEMS (3)
osteoarthritis of both kn...
type 2 diabetes
Hypertension
ALLERGIES (1)
hives Penicillin
MEDICATIONS (1)
50mg Sertraline 50mg
ALERTS (0)
No active alerts
What still needs attention

Encounter Complete

This encounter is signed and closed.

Encounter Progress 100% of required work complete
Encounter complete.
Clinical Actions all 2 resolved
Everything required for this visit is documented.
✓ Complete Good Faith Exam done
Documentation generated automatically when this was completed.
✓ Capture Photos done
Documentation generated automatically when this was completed.
Treatment Photographs & Dose Mapping
Before photograph ?
After photograph ?
✎ Facial Injection Dose Mapping Diagram
Anatomical Landmark Distribution · Botox Cosmetic (OnabotulinumtoxinA) · 100U vial reconstituted with 2.5 mL 0.9% NaCl (4.0 U / 0.1 mL)
Total Dose: 34 Units
11 Injection Sites Mapped
ANATOMICAL INJECTION SITES
2.5 2.5 2.5 2.5 FRONTALIS (10 U) GLABELLAR COMPLEX (20 U) 4U 4U 4U 4U 4U 2U 2U
Forehead (10U) Glabella (20U) Canthal (4U)
DOSE BREAKDOWN BY ANATOMICAL LANDMARK
Target Muscle / Area Sites Dose Plane & Technique
Corrugator Supercilii 4 16 U Deep IM (90°), medial/lateral pinch
Procerus (Center) 1 4 U Deep IM (90°), nasal bridge apex
Frontalis (Mid-Forehead) 4 10 U Mid-dermal / SC (45°), ≥2cm above rim
Orbicularis Oculi (Lateral) 2 4 U Superficial subdermal (30°), 1cm lateral
Total Documented 11 sites 34 U ✓ Protocol Ratified
Product: Botox Cosmetic 100U (Allergan)
Lot #: C3829-A1 (Exp: 2027-04)
Dilution: 2.5 mL bacteriostatic 0.9% NaCl (4.0 Units / 0.1 mL) · Gauge: 32G x 4mm
Documents on this visit
What has been documented and filed for this encounter
Clinical Photography (Before & After Photos)
Filed Record
COMPLETED · 2026-09-20 00:19:22
CONSENT ON FILE: ✓ Yes  ·  CALIBRATED: ✓ Yes  ·  COMPLETED BY: DLP Clinician
[ { "phase": "BEFORE", "view": "FRONTAL", "title": "Frontal - Glabella / Forehead baseline" }, { "phase": "BEFORE", "view": "LEFT_OBLIQUE", "title": "Left Oblique 45° - Lateral canthal" }, { "phase": "BEFORE", "view": "RIGHT_OBLIQUE", "title": "Right Oblique 45° - Lateral canthal" } ]
Good Faith Exam
Filed Record
COMPLETED · 2026-09-20 00:19:22
COMPLETED BY: DLP  ·  Standard clinical aesthetics safety clearance ratified.
Post-Procedure Aftercare Instructions
Filed Record
COMPLETED · 2026-09-20 00:14:31
INSTRUCTIONS DELIVERED: ✓ Yes  ·  CLIENT COPY PROVIDED: ✓ Yes  ·  EMERGENCY CONTACT PROVIDED: ✓ Yes  ·  ICE COMPRESS REVIEW: ✓ Yes
Facial Injection Dose Mapping & Treatment Record
Filed Record
COMPLETED · 2026-09-20 00:09:31
LOT: LOT-OAS-ESTABLISHED  ·  TOTAL DOSE: 34  ·  PRODUCT: Botox Cosmetic 100U  ·  TECHNIQUE: Deep IM and subdermal micro-aliquots  ·  SITES: 11  ·  TOLERANCE: Well tolerated, no adverse event
Baseline Appearance & MRD-1 Record
Filed Record
COMPLETED · 2026-09-19 23:59:31
MRD1 RIGHT: 4.1  ·  MRD1 LEFT: 4.2  ·  GLABELLA REST: Mild rhytids  ·  BROW PTOSIS RISK: Low
Cosmetic Procedure Informed Consent
Filed Record
COMPLETED · 2026-09-19 23:54:31
RISKS UNDERSTOOD: ✓ Yes  ·  CONSENT SIGNED: ✓ Yes  ·  PHOTOGRAPH CONSENT: ✓ Yes  ·  PROCEDURE: Botox Cosmetic / Facial Aesthetics
📄 Forms Search & Repository Catalog
2,110 Total Templates
Search and attach specialty clinical templates from the repository (2,110+ forms across 80+ clinical disciplines) directly to this encounter record.
Showing 4 of 2,110 matches (type more to narrow) Click "+ Attach" to file to encounter · "Launch ↗" to edit in new tab
Acne Vulgaris Management Visit Dermatology
acne_vulgaris_cf
Acupuncture (default) Clinical
acupuncture_cf
Acute Care / Sick Visit Primary Care
acute_care_visit_cf
Acute Kidney Injury Management Nephrology
aki_management_cf
Encounter Information
Intake / Vitals
Vitals History (this encounter)
Taken HR Sys Dia O2% Temp Resp Wt Ht BMI Pain Notes
09:35 AM 72 118 76 99% 98.4 16 138 5'6" 22.3 0 Resting baseline vitals prior to aesthetic neurotoxin injection
SOAP Clinical Documentation
🛡 In-Flight OmniGuard™ DLP Keystroke Scanner SAFEGUARD ACTIVE

Type sensitive clinical data below (e.g. SSN, credit cards, dates of birth). OmniGuard™ intercepts and redacts PHI in-flight before tokenization.

Protected Stream: Real-time redactor active. Awaiting keystrokes...
Diagnoses (ICD-10)
Code Description Order Primary Actions
L90.8 Other atrophic disorders of skin (Facial Rhytids) 1 Yes
M17.0 Bilateral primary osteoarthritis of knee 2 No
E11.9 Type 2 diabetes mellitus without complications 3 No
I10 Essential (primary) hypertension 4 No
Problem List (chart — carries forward to future visits)
ICD-10 Problem Status Onset Actions
M17.0 Bilateral primary osteoarthritis of knee Active 2021-03-15
E11.9 Type 2 diabetes mellitus without complications Active 2019-08-20
I10 Essential (primary) hypertension Active 2018-11-04
Current Medicines (chart medication list)
Medication Dosage Frequency Start Date Status Source Actions
Sertraline HCl 50 mg once daily 2022-01-10 Reconciled Encounter reviewed
Metformin HCl 500 mg twice daily with meals 2019-09-01 Active Encounter reviewed
Lisinopril 10 mg once daily morning 2018-11-10 Active Encounter reviewed
Order Medications (eRx)
Drug Sig / Directions Qty Status Pharmacy Actions
Botox Cosmetic (OnabotulinumtoxinA) 100U As directed per dose map protocol 1 vial Draft Order ReCenter Oasis Beverly Hills In-Clinic Pharmacy
Pharmacy Directory
Pharmacy Address City State Phone NCPDP Active
ReCenter Oasis In-Clinic Pharmacy 9465 Wilshire Blvd Ste 300 Beverly Hills CA (310) 555-0199 0582910 Yes
Clinical Orders
Type Order Description Priority Status Due Date Action
Procedure Facial Neurotoxin Rejuvenation (34 Units) Routine Signed 2026-09-20
Lab Hemoglobin A1c (Annual Glycemic Monitoring) Routine Signed 2026-10-15
Procedure Clinical Photography Verification (Before/After) Routine Signed 2026-09-20
Referral Annual Ophthalmologic Diabetic Retinal Exam Routine Draft 2026-11-01
11-Form Clinical Aesthetics Consent Matrix 11 of 11 Completed
Form Title Version Signed Timestamp Witness / Provider Status Action
Cosmetic Botulinum Toxin Informed Consent v4.2 2026-09-19 23:54:31 Dr. Evelyn Reed, MD Completed
Clinical Photography & Media Release Consent v3.0 2026-09-20 00:02:11 DLP Clinician Completed
Good Faith Examination (GFE) Physician Clearance v2.1 2026-09-20 00:05:44 Dr. Elliot Nazari, MD Completed
Off-Label Neuromodulator Administration Disclosure v1.8 2026-09-19 23:55:02 Dr. Evelyn Reed, MD Completed
Post-Procedure Recovery & Emergency Protocol Consent v2.0 2026-09-20 00:14:31 DLP Clinician Completed
Adverse Reaction & Ptosis Risk Acknowledgment v3.1 2026-09-19 23:56:18 Dr. Evelyn Reed, MD Completed
Dermal Filler & Vascular Occlusion Disclosure v4.0 2026-09-19 23:57:00 Dr. Evelyn Reed, MD Completed
Hyaluronidase Emergency Dissolving Consent v2.4 2026-09-19 23:57:45 Dr. Evelyn Reed, MD Completed
Chemical Peel & Active Resurfacing Consent v1.5 2026-09-19 23:58:12 DLP Clinician Completed
Microneedling & RF Device Procedure Consent v2.2 2026-09-19 23:58:50 DLP Clinician Completed
Telehealth Aesthetics Consultation Agreement v3.3 2026-09-19 23:59:15 Dr. Evelyn Reed, MD Completed