In the past twenty years, the American population has seen an increased demand for non-surgical minimally invasive facial rejuvenation solutions for the ageing process. However, this widespread and increased demand for cosmetic injections brings a greater propensity for complications and adverse events. Choosing suitable patients for dermal fillers is essential, as is concrete knowledge of the factors related to adverse events; however, there was no standardized tool to facilitate this process. The Joint Commission’s Universal Safety checklist tools have been integrated into hospital surgical operating rooms and ambulatory outpatient settings across America and have successfully reduced errors in patient safety and outcomes. This paper establishes the importance of integrating a standardized pre-injection safety tool (the Assessment Cosmetic Injection Safety Tool, ACIST) into the cosmetic practice to decrease the incidence of adverse events associated with dermal fillers and to achieve optimal patient satisfaction and outcomes. The ACIST was designed from evidence-based literature, piloted at a southern U.S. urban cosmetic practice, finalized based on feedback from the pilot, and disseminated to cosmetic nurse injectors.