[guided]The goal is to compute $\Delta(u\circ f)$, but $u$ is naturally a function of the target coordinates while $u\circ f$ is a function of the source coordinates. That is why we introduced
\begin{align*}
v:\widetilde U &\to \mathbb R
\end{align*}
by
\begin{align*}
v(s,t):=\widetilde u(p(s,t),q(s,t)).
\end{align*}
Here $(s,t)$ are source variables, while $(x,y)$ are target variables. Since $\widetilde u\in C^2(\widetilde V;\mathbb R)$ and $p,q\in C^2(\widetilde U;\mathbb R)$, the ordinary [multivariable chain rule](/theorems/830) applies twice, so $v\in C^2(\widetilde U;\mathbb R)$.
Fix a point $(s,t)\in \widetilde U$. In the following formulas, the derivatives $\widetilde u_x,\widetilde u_y,\widetilde u_{xx},\widetilde u_{xy},\widetilde u_{yy}$ are evaluated at the target point $(p(s,t),q(s,t))$. First differentiating in the $s$-direction gives
\begin{align*}
v_s=\widetilde u_x p_s+\widetilde u_y q_s.
\end{align*}
Differentiating this identity once more in $s$, using the product rule and the chain rule on $\widetilde u_x(p,q)$ and $\widetilde u_y(p,q)$, gives
\begin{align*}
v_{ss}=\widetilde u_{xx}p_s^2+\widetilde u_{xy}q_s p_s+\widetilde u_x p_{ss}+\widetilde u_{yx}p_s q_s+\widetilde u_{yy}q_s^2+\widetilde u_y q_{ss}.
\end{align*}
Because $\widetilde u\in C^2$, Clairaut's theorem gives $\widetilde u_{xy}=\widetilde u_{yx}$, so this becomes
\begin{align*}
v_{ss}=\widetilde u_{xx}p_s^2+2\widetilde u_{xy}p_s q_s+\widetilde u_{yy}q_s^2+\widetilde u_x p_{ss}+\widetilde u_y q_{ss}.
\end{align*}
The same computation in the $t$-direction gives
\begin{align*}
v_{tt}=\widetilde u_{xx}p_t^2+2\widetilde u_{xy}p_t q_t+\widetilde u_{yy}q_t^2+\widetilde u_x p_{tt}+\widetilde u_y q_{tt}.
\end{align*}
The Laplacian in the source variables is $\Delta v=v_{ss}+v_{tt}$. Adding the two displayed identities and grouping the coefficients of each derivative of $\widetilde u$ gives
\begin{align*}
\Delta v=(p_s^2+p_t^2)\widetilde u_{xx}+2(p_s q_s+p_t q_t)\widetilde u_{xy}+(q_s^2+q_t^2)\widetilde u_{yy}+\widetilde u_x(p_{ss}+p_{tt})+\widetilde u_y(q_{ss}+q_{tt}).
\end{align*}
This formula is the exact point where conformality will enter: the Cauchy-Riemann equations will simplify the three Hessian coefficients, and harmonicity of $p$ and $q$ will eliminate the first-derivative terms.[/guided]