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MonaLisa Touch Patient QuestionnaireDate: PreTreatment 1 Patients name: PreTreatment 2 Patients DOB: PreTreatment 3 Follow up in monthsPlease indicate the level of discomfort you are experiencing.

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How to fill out the MonaLisa Touch Patient Questionnaire online

Completing the MonaLisa Touch Patient Questionnaire online is an essential step in facilitating your treatment plan. This guide will provide you with clear instructions on how to accurately fill out the form, ensuring a smooth process for you.

Follow the steps to effectively complete the questionnaire.

  1. Press the ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering your name in the designated field labeled 'Patient's name'. This is crucial for accurately identifying your submission.
  3. Fill in your date of birth in the 'Patient's DOB' field. This information is essential for verifying your identity and age.
  4. Indicate whether this is a pre-treatment or follow-up questionnaire by checking the appropriate box provided.
  5. Rate your level of discomfort in various categories on a scale from 0 to 10. Fill in each rating for pain, vaginal itching, painful sexual intercourse, vaginal burning, vaginal dryness, and painful urination. Use the scale provided to ensure clarity in your responses.
  6. In the comments section, provide any additional information or concerns you may have regarding your symptoms or treatment. This section allows you to elaborate on your experience.
  7. Review your entries to ensure all information is accurate and complete. This is important for the healthcare professionals who will review your questionnaire.
  8. Once satisfied with your responses, you can choose to save the changes, download the document, print it, or share it based on the options available.

Complete your documents online to facilitate your MonaLisa Touch treatment experience.

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The probe delivers gentle laser energy to your vaginal tissues. Your treatment lasts only about five minutes.

My doctor had diagnosed me with frequent urinary tract infections and actually I always felt like I had one. Mona Lisa did the trick. No more infections and I felt normal, no more daily, itching, dryness and burning. It was so easy and has made me feel so much better everyday.

It has been clinically proven to provide effective results for vaginal dryness, vaginal laxity and mild urinary incontinence. The Mona Lisa Touch can also improve your sexual health. After just a few treatments, many women experience an improvement in symptoms including dryness, burning, itching, and laxity.

The MonaLisa Touch is $1,000 per treatment or $2,700 pre-paid.

A: The MonaLisa Touch is currently not covered by insurance or Medicare, as no procedure code has been established.

Does insurance cover the procedure? MonaLisa Touch is not covered by health insurance. Although there is an out of pocket cost for the MonaLisa Touch treatment, the benefits are profound and some patients have called it life changing .

Avoid lifting heavy weights or doing intense physical exercise for 3-4 days following the treatment. Refrain from sexual intercourse for a week (7 days) after the treatment. Wear loose, cotton underwear.

Estrogen has been approved for use for over 40 years and is considered the standard of care. There are no procedure codes for MonaLisa Touch and therefore not billable to insurance.

It has been clinically proven to provide effective results for vaginal dryness, vaginal laxity and mild urinary incontinence. The Mona Lisa Touch can also improve your sexual health. After just a few treatments, many women experience an improvement in symptoms including dryness, burning, itching, and laxity.

Mona Lisa Touch procedure is definitely worth it! I was truly amazed with the improvements after the very first treatment.

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