You can save time on your initial visit if you print these forms, fill them out at home, and bring them with you. Some questions may require you to look up information about the health history of you and your family. Searching these health records at home will allow you to provide us with the most accurate information possible. Having your most complete and accurate health history will help us better ensure the safety of your treatment.
All forms listed below are in Microsoft Word. You may open and print a form by clicking its link.
Patient Registration Form
For your initial visit, please print and fill out this form that asks about your basic information: name, address, how to reach you, date of birth, social security, employment, and insurance.
Personal History
This form asks about your health history and that of your blood relatives. It also asks you to list medications you are taking and past surgeries you have had.
Contact Preference
This form makes sure we have your preferred means of contacting you: telephone, mail, or email.
Financial Policy
This 2-page sheet, which must be signed prior to any treatment, explains the financial policies of BodyAesthetic Plastic Surgery.
|
