Patient forms.

Speed up your visit by completing your forms at home. Just print and fill out the ones you need, and then bring them to the office with you.

Authorizations, Warnings and General Information

General Health Questionnaire
Authorization for Release of Records
Authorization for Medical Treatment and Financial Responsibility
Medication Alert
Smoking and Plastic Surgery

Consent Forms – Face

Blepharoplasty (Eyelid Lift)
Brow Lift (Forehead Lift)
Face Lift
Otoplasty (Ear Correction)
Rhinoplasty (“Nose Job”)
Septoplasty (Correction of Deviated Septum)

Consent Forms – Body

Abdominoplasty (Tummy Tuck)
Abdominoplasty – Mini  (Mini-Tummy Tuck)
Body Lift
Brachioplasty (Arm Lift)
Buttock Lift
Liposuction
Medial Thigh Lift
 

Consent Forms – Breasts

Breast Augmentation – Saline
Breast Augmentation – Silicone Gel
Breast Implant Removal
Mastopexy
Reduction Mammaplasty
 

Consent Forms – Reconstructive

Breast Reconstruction – Latissimus Muscle Flap
Breast Reconstruction with Tissue Expander
Breast Reconstruction with TRAM Flap
Gynecomastia (Male Breast Development)
Nipple Reconstruction
Permanent Implant Following Breast Reconstruction
Scar Revision
 

Consent Forms – Non-invasive procedures

BOTOX®
Chemical Peel and Skin Treatments
Radiesse
Hyaluronic Acid Fillers (ie. Juvaderm and Restylane®)
Fractionated Laser Skin Resurfacing
Intense Pulse Light Skin Treatments
Laser Hair Removal
Laser Vein Treatment

Preparation / Care Sheets

Abdominoplasty / Body Lift
Breast Augmentation
Breast Reduction / Breast Lift
Breast Tissue Expander
Facelift / Eyelid
Home Care After Nipple Reconstruction
Liposuction