Patient Info

Office Forms

Prior to your first appointment, download, print and fill out the "New Patient Package" consisting of three forms: Registration, Medical History and Signature on File. This will save you valuable time and make for complete information, as some information required will most likely be in your records at home.

If you need help with any paperwork, please do not hesitate to ask a member of the staff for assistance.

Note: Forms are provided in Adobe Acrobat PDF format. If you do not have Adobe Reader, click here to download Acrobat Reader free-of-charge.

• Auto Accident /  No-Fault Information Request
• Botox / Fillers New Patient
• Workers Compensation Information
• Instruction for Sun Screen Use
• Post-Operative Plastic Surgical Care
• ER Consent
• Release of Health Information
• Kybella Consent Form
• New Patient Package
  • Patient Registration
  • Medical History
  • Signature on File

Insurance Information

While Associated Plastic Surgeons & Consultants, PC no longer participates with any health insurance plans other than those outlined below for reimbursable procedures, our office will frequently accept "Insurance Allowance." Insurance Allowance is defined as insurance company reimbursement plus deductible and co-insurance (if any). The patient would therefore be responsible for their deductible and co-insurance. This policy varies from case to case – please be sure to ask.

Please remember, cosmetic surgical procedures are usually not reimbursed by insurance coverage. We will be more than happy to request prior approval for procedures we anticipate be covered.

We participate with:

• Medicare*
• No Fault*
• Worker’s Compensation*

* Within the guidelines of your policy, providing proper information for correct filing.