Patient Forms

Plastic Surgery in Weston, Fort Lauderdale, Miami, Plantation and Davie, Florida

Feel free to review the following forms.

For  your convenience these forms may be printed and brought in at the time of your consultation or you may fill then out as an attachment and email them to our office.

  1. New Patient Questionnaire
  2. Patient Health Information
  3. Patient Bill of Rights
  4. Notice of Privacy Practice
  5. Pre-Operative Instructions General
  6. Post-Operative Instructions General
  7. Pre-Operative Shopping List
  8. The Pills I Take
  9. Your Anesthetia Experience
  10. Financial and Cancellation Policy
  11. Financial Policy Regarding Revision and Complications
  12. HIPPA
  13. Medications to Avoid
  14. Photographic Authorization and Release
  15. Pregnancy Waiver

Please download and complete the forms.