Forms

Below are forms that you can print and fill out prior to your visit.

History and physical
This form is what the physician reviews before meeting with you. It can be filled in when you visit or you can print it, fill it in and bring the form with you. Click these links to view or print:

Patient registration

The patient registration form is for you to authorize us to treat you, bill your insurance and allow us to release information required to process your insurance claims. Click the following link to view or print: Patient Registration

Photo consent

Before and after pictures will be taken to document your appearance before and after a procedure. Click here for the consent form. Consent Form

Skin Rejuvenation and Laser Treatments

Your practitioner reviews the Medical History and Skin Care Questionnaire prior to your visit and performing aesthetic services. It allows your practitioner to personalize your skin rejuvenation and laser therapies.

Insurance and information release