Patient Forms

Here are our patient forms. Please print these out and fill them in prior to coming into the office. The forms are grouped by what you will need depending on the type of procedure you are scheduled for:

Non-Surgical Nose Job

Medical History
Radiesse Consent
Hippa
Arbitration Agreement
Cancellation Policy

Non-Surgical Chin Enhancement

Medical History
Radiesse Consent
Hippa
Arbitration Agreement
Cancellation Policy

Non-Surgical Cheek

Medical History
Radiesse Consent
Hippa
Arbitration Agreement
Cancellation Policy

Artefill Non-Surgical Nose Job

Medical History
Artefill consent
Hippa
Arbitration Agreement
Cancellation Policy

Artefill Non-Surgical Chin Enhancement

Medical History
Artefill consent
Hippa
Arbitration Agreement
Cancellation Policy

Non-Surgical Blepharoplasty

Medical History
Juvederm Consent
Hippa
Arbitration Agreement
Cancellation Policy

Juvederm

Medical History
Juvederm Consent
Hippa
Arbitration Agreement
Cancellation Policy

Botox Brow Lift

Medical History
Botox Consent
Hippa
Arbitration Agreement
Cancellation Policy

Botox for TMD

Medical History
Botox Consent
Hippa
Arbitration Agreement
Cancellation Policy

Radiesse

Medical History
Radiesse Consent
Hippa
Arbitration Agreement
Cancellation Policy

Sculptra

Medical History
Sculptra Consent
Hippa
Arbitration Agreement
Cancellation Policy

Botox

Medical History
Botox Consent
Hippa
Arbitration Agreement
Cancellation Policy

Dysport

Medical History
Dysport Consent
Hippa
Arbitration Agreement
Cancellation Policy

Artefill

Medical History
Artefill Consent
Hippa
Arbitration Agreement
Cancellation Policy

Active/Total FX CO2 Laser

Medical History
Active Total FX Consent
Hippa
Arbitration Agreement
Cancellation Policy

Fraxel

Medical History
Fraxel consent
Hippa
Arbitration Agreement
Cancellation Policy

Thermage

Medical History
Thermage Consent
Hippa
Arbitration Agreement
Cancellation Policy

Veinwave

Medical History
Veinwave Consent
Hippa
Arbitration Agreement
Cancellation Policy

Laser Hair Removal

Medical History
LHR Consent
Hippa
Arbitration Agreement
Cancellation Policy

Omnilux Light Based Treatment

Medical History
Omnilux Light Consent
Hippa
Arbitration Agreement
Cancellation Policy

Photodynamic Therapy

Medical History
PDT Consent
Hippa
Arbitration Agreement
Cancellation Policy

Microdermabrasion

Medical History
Micro Consent
Hippa
Arbitration Agreement
Cancellation Policy

VI Peel

Medical History
Vi Peel Consent
Hippa
Arbitration Agreement
Cancellation Policy

Vitalize Peel

Medical History
Vitalize Peel Consent
Hippa
Arbitration Agreement
Cancellation Policy

VelaShape

Medical History
Velashape Consent
Hippa
Arbitration Agreement
Cancellation Policy

IPL/Photofacial

Medical History
IPL Consent
Hippa
Arbitration Agreement
Cancellation Policy


11645 Wilshire Blvd., Suite 800. Los Angeles, CA 90025  |  (310) 443-5273