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Please remember to bring a photo ID to your appointment. This is in conjunction with upcoming federal guidelines that were established to protect you against medical identity theft.

New Patient Forms:
  • Patient Registration Form
    Required for new patients - Please print, complete and bring to your appointment.

  • Assignment of Benefits and HIPAA Notice
    Required for new patients - Please print, complete and bring to your appointment

  • Appointment Cancellation/ No Show Policy
    Required for all patients - Please print, complete and bring to your appointment

  • Diagnostic Procedure Financial Notice
    Required for new patients - Please print, complete and bring to your appointment

  • Minor Consent Form
    Required for a minor that is coming to an appointment without a parent or legal guardian

  • Notice of Privacy Practices
    Please review

Established Patient Forms:
  • Appointment Cancellation/ No Show Policy
    Required for all patients - Please print, complete and bring to your appointment

Miscellaneous Forms:
  • Minor Consent Form
    Required for a minor that is coming to an appointment without a parent or legal guardian

The Facial Cosmetic Center Forms:
  • The Facial Cosmetic Center Questionnaire
    Our online interactive facial center questionnaire.
 
FEB
1
February is Kids ENT health month

JAN
6
Chinese boy lucky after chopstick enters skull

MAR
16
Botox Cosmetic Day with Dr Powell

APR
15
The Facial Cosmetic Center Open House
 
     
 
 
     
 
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