OFFICE RECEPTION
Office Reception
Click on the links below to download the forms in which you are interested.
INSTRUCTIONS
Instructions for new patients
1
Download the forms
Download and print all necessary forms below for your initial visit.
2
Complete the information
Complete all forms clearly and legibly. Bring a list of your current medications.
3
Bring documentation
Don't forget to bring your insurance card, photo ID, and any relevant previous test results.
4
Arrive early
Please arrive 15 minutes before your scheduled appointment to complete the admission process.
Alternative: Complete Online Form
Save time by submitting your consent form digitally through our secure online platform. Available 24/7 from the comfort of your home.
DOWNLOADABLE FORMS
Available Forms
New Patient Forms – Cosmetic
PDF Document
New Patient Forms – Insurance
PDF Document
Medication list
PDF Document
Authorizations
PDF Document
HIPAA Notice of Privacy Practices
PDF Document
Consent for Surgery
PDF Document
Consent to Botulinum Toxin Treatment for Facial Spasms
PDF Document
Consent to Botulinum Toxin Treatment for Wrinkles
PDF Document
Latisse Ophthalmic Solution Consent
PDF Document
Medication Guide Dysport
PDF Document
Botox Guide for Patients
PDF Document
Botox Guide for Doctors
PDF Document
ONLINE CONSENT
Submit Consent Form
I hereby provide my consent
NOTICE TO PATIENTS
Notice to patients
- Medical doctors are licensed and regulated by the Medical Board of California.
- To check up on a license or to file a complaint go to www.mbc.ca.gov, email licensecheck@mbc.ca.gov, or call (800) 633-2322.