For your convenience, we have provided downloadable copies of the New Patient Forms at the links below. Simply print and complete the top five (5) forms, and bring them with you to your visit.

Non-Medicare Patient Forms

New Patient Registration
Financial Policy and Agreement
Medical History Form
Authorization for Release of Information
HIPAA Acknowledgement of NPP
HIPAA Notice of Privacy Policies (Patient Copy)

Cosmetic Consult

Cosmetic Patient Consultation Form
SculpSure® Consultation Form
Sculpsure Clinical Treatment Consultation Form
Photo Release Form