Patient Forms to Download
Listed below are some of the forms that we routinely use in our office. You may print and fill out now to save you time once you arrive at our office. Click on any of the links to download a form. You will need Adobe Acrobat Reader installed on your computer to automatically open the file – you may download the program for free .
- Authorization – Release of Health Information Form
- Initial GYN Visit Patient Forms – English
- Initial Cosmetic Visit Patient Forms – English
- Patient’s Bill of Rights and Responsibilities
Cosmetic Surgery Financing
Fees and Financing
We are committed to providing the best possible care and to keeping costs as low as possible. We will discuss estimated fees with you prior to surgery. Cosmetic surgery is elective and therefore not covered by insurance. We accept most major credit cards, checks, and cash.
Now patients have the option to finance their procedure through cosmetic surgery financing companies. Cosmetic surgery financing companies were created for people who don’t want to tie up their traditional credit sources with medical debt or those who simply can’t afford to pay out-of-pocket healthcare charges at one time. It is no longer necessary to delay a surgical procedure that you really want, nor worry about the inability to pay for treatment. Cosmetic surgery financing companies allow you to make low monthly payments over an extended period of time.
Applying is easy. Most of the time, the same day you apply, the cosmetic surgery financing companies can help you secure financing so you can schedule your procedure right away. If you would like assistance in applying, our staff will be more than happy to apply for you online once you have completed and signed the application form.
- CareCredit – You may apply online at www.carecredit.com. The options our office offers with this company are the 3- or 6-month no-interest payment plans and the extended payment plans ($1,000 minimum charge).
- SurgeryLoans.com – You may apply online at www.surgeryloans.com or by calling 1-888-502-8020. Our office is currently offering up to 6 months no interest* with this financing company.
* Subject to credit approval for the various lender programs available