Patient Paperwork

PLEASE READ BEFORE COMING IN

Below I have attached some documents for you to fill out, please send back or bring with you to your appointment with an attached copy (you can take a photo of it on your mobile device and email it back to this email) of your insurance and ID. Unless you’re coming in for an insurance consultation we don’t bill insurance – we just like to keep a copy on file.

We do require a minimum BMI of 33 or under to be seen. We also require you to wear a mask, if you don’t have one we have some provided. Please come alone if possible and ABSOLUTELY NO KIDS. We are taking extra precautions to protect our office and patients from COVID-19.

IF YOU HAVE BEEN EXPOSED TO SOMEONE WHO HAS COVID OR ARE SHOWING SYMPTOMS OF COVID PLEASE RESCHEDULE.

Appointment policy: If you are 5 min late we will call you to reschedule your appointment. Cancellations MUST be done AT LEAST 24 HOURS BEFORE your scheduled appointment. PLEASE ARRIVE 15 MIN EARLIER THAN SCHEDULED APPOINTMENT

Breast Consultations

Breast Questionnaire Form Breast Reduction Questionnaire Form

Rhinoplasty Consultations

Nasal Surgery History Form

All Procedure Consultations (MANDATORY)

Patient Information Form Medical History Form HIPAA Privacy Form