Patient Forms

Click on a Title to see a link to the PDF file and a description.


  1.   Abdominoplasty Surgery
This is an informed-consent document that has been prepared to help your plastic surgeon inform you of abdominoplasty surgery, its risks, as well as alternative treatments.

  2.   Augmentation Mammaplasty Revision with Larger Implant than Recommended
I, __________________________, have discussed with Dr. and fully understand and accept the following with regard to my desire for breast augmentation using an implant larger than Dr. feels is optimal for my breast tissue and my body proportions. I acknowledge that I fully understand each item listed below.

  3.   Augmentation Mammaplasty with Larger Implant than Recommended
I, __________________________, have discussed with Dr. and fully understand and accept the following with regard to my desire for breast augmentation using an implant larger than Dr. feels is optimal for my breast tissue and my body proportions. I acknowledge that I fully understand each item listed below.

  4.   Augmentation Mammaplasty with Saline-Filled Implants
This is an informed-consent document that has been prepared to help inform you about augmentation mammaplasty surgery with saline-filled implants, its risks, as well as alternative treatment(s).

  5.   Augmentation Mammaplasty with Silicone Gel-Filled Implants
This is an informed-consent document that has been prepared to help inform you about augmentation mammaplasty surgery with silicone gel-filled implants, its risks, as well as alternative treatment(s).

  6.   Blehparoplasty Surgery
This is an informed-consent document which has been prepared to help inform you about blepharoplasty (eyelid) surgery, its risks, as well as alternative treatment(s).

  7.   Body Lift Surgery
This is an informed-consent document that has been prepared to help inform you concerning body lift surgery (also commonly called lower body lift, belt lipectomy, circumferential lipectomy, or torsoplasty), its risks, as well as alternative treatment(s).

  8.   Botox® Injection
This is an informed-consent document which has been prepared to help your plastic surgeon inform you concerning BOTOX® (Botulina Toxin Type A, Allergan) injection, its risks, and alternative treatments.

  9.   Brachioplasty
This is an informed-consent document that has been prepared to help inform you concerning brachioplasty surgery(s), its risks, and alternative treatment(s).

10.   Breast Implant Removal
This is an informed-consent document that has been prepared to help inform you about the removal of breast implant(s), its risks, and alternative treatment(s).

11.   Breast Lift (Mastopexy)
This is an informed-consent document that has been prepared to help inform you about mastopexy (breast lift) surgery, its risks, as well as alternative treatment(s).

12.   Breast Reconstruction with Latissimus Muscle Flap
This informed-consent document has been prepared to help inform you of breast reconstruction with latissimus muscle flap surgery, its risks, and alternative treatments.

13.   Breast Reconstruction with Tissue Expander
This informed-consent document has been prepared to help inform you of breast reconstruction with a tissue expander, its risks, and alternative treatment.

14.   Breast Reconstruction with Tram Abdominal Muscle Flap
This informed-consent document has been prepared to help inform you of breast reconstruction with TRAM abdominal muscle flap surgery, its risks, and alternative treatment(s).

15.   Brow Lift Surgery
This is an informed-consent document that has been prepared to help inform you of brow lift surgery, its risks, as well as alternative treatments.

16.   Buttock Lift Surgery
This is an informed-consent document that has been prepared to help inform you concerning buttock lift surgery, its risks, as well as alternative treatment(s).

17.   Chemical Skin Peels and Treatments
This is an informed-consent document that has been prepared to help inform you about chemical skin peel and skin treatment procedure(s), its risks, and alternative treatment.

18.   Facelift Surgery (Rhytidectomy)
This is an informed-consent document that has been prepared to help inform you concerning facelift surgery, its risks, as well as alternative treatment(s).

19.   Ganglion Cyst Surgery
This is an informed-consent document that has been prepared to help inform you of ganglion cyst surgery, its risks, as well as alternative treatments.

20.   Gynecomastia Surgery
This is an informed-consent document that has been prepared to help inform you concerning gynecomastia (male breast reduction) surgery, its risks, as well as alternative treatment(s).

21.   Hylaform® Injection
This informed-consent document has been prepared to help inform you about Hylaform® (animal-origin, stabilized hyaluronic acid, INAMED) tissue-filler injection therapy, its risks, and alternative treatments.

22.   Laser Resurfacing Procedures of Skin
This informed-consent document has been prepared to help inform you about laser resurfacing procedures of skin, its risks, as well as alternative treatment(s).

23.   Liposuction (Suction-Assisted Lipectomy Surgery) (Ultrasound-Assisted Lipectomy Surgery)
This is an informed-consent document that has been prepared to help inform you concerning liposuction surgery (suction-assisted lipectomy and ultrasound-assisted lipectomy), its risks, and alternative treatment.

24.   Medial Thigh Lift Surgery
This is an informed-consent document that has been prepared to help inform you concerning medial thigh lift surgery, its risks, as well as alternative treatment(s).

25.   Mini-Abdominoplasty Surgery
This is an informed-consent document that has been prepared to help inform you of mini-abdominoplasty surgery, its risks, as well as alternative treatments.

26.   Nasal Injury Repair Surgery
This is an informed consent document that has been prepared to help inform you concerning nasal injury repair surgery, its risks, and alternative treatment.

27.   Nipple Reconstruction Surgery
This informed-consent document has been prepared to help inform you about nipple reconstruction surgery, its risks, and alternative treatment(s).

28.   Open Capsulectomy with Breast Implant Replacement Using Silicone Gel-Filled Implants
This is an informed-consent document that has been prepared to help inform you about open capsulectomy and breast implant exchange using silicone gel-filled implants, its risks, and alternative treatments.

29.   Open Capsulotomy with Breast Implant Replacement Using Saline-Filled Implants
This is an informed-consent document that has been prepared to help inform you about open capsulotomy and breast implant exchange using saline-filled implants, its risks, and alternative treatments.

30.   Otoplasty Surgery
This is an informed-consent document that has been prepared to help inform you of otoplasty surgery, its risks, as well as alternative treatments.

31.   Placement of Permanent Breast Implant Following Breast Reconstruction by Tissue Expansion
This informed-consent document has been prepared to help inform you about placement of permanent breast implant following tissue expansion breast reconstruction, its risks, and alternative treatment(s).

32.   Reduction Mammaplasty
This is an informed-consent document that has been prepared to help inform you concerning reduction mammaplasty surgery (breast reduction), its risks, as well as alternative treatment(s).

33.   Restylane® Injection
This is an informed-consent document which has been prepared to help your plastic surgeon inform you concerning Restylane® (Non-Animal Stabilized Hyaluronic Acid, Medicis Aesthetics) tissue filler injection therapy, its risks, and alternative treatments.

34.   Rhinoplasty Surgery
This is an informed consent document that has been prepared to assist your plastic surgeon inform you concerning rhinoplasty surgery, its risks, and alternative treatment.

35.   Scar Revision Surgery
This is an informed-consent document that has been prepared to help inform you concerning scar revision surgery(s), its risks, as well as alternative treatment(s).

36.   Septoplasty Surgery
This is an informed consent document that has been prepared to help inform you concerning septoplasty surgery, its risks, and alternative treatment.

37.   Skin Cancer Surgery
This is an informed-consent document that has been prepared to help your plastic surgeon inform you about skin cancer surgery(s), its risks, as well as alternative treatment(s).

38.   Skin Graft Surgery
This is an informed-consent document that has been prepared to inform you of skin graft surgery, its risks, as well as alternative treatments.

39.   Skin Lesion / Skin Tumor Removal
This is an informed-consent document that has been prepared to help your plastic surgeon inform you concerning skin lesion / skin tumor surgery(s), its risks, as well as alternative treatment(s).

40.   Tip Rhinoplasty Surgery
This is an informed consent document that has been prepared to help inform you concerning tip rhinoplasty surgery, its risks, and alternative treatment.