Patient Forms
We know that filling out paperwork isn’t fun. There is information we need for all of our patients, and notices we are required by law to give you. To make the process less painful, we offer you several options for filling out forms.
- We will text / email new patients a link to forms they can complete on their smart phone, tablet or computer. This is the fastest, easiest way for us to get the information and share with you what we need to share.
- If you prefer to fill out the forms at our office, please come 20 minutes early to your appointment. We will offer you a tablet on which to do your registration, or if you feel uncomfortable using a tablet, we can offer you paper forms.
- If you prefer paper forms, you can complete them in advance. Below you will find the necessary forms and notices.
Please remember to bring your drivers license or ID, your insurance card, your medication list, and your form of payment, if applicable to your appointment.
For your convenience, the following Patient Forms
are available for downloading and printing:
When you are going to be seeing our Skin Care Specialist for the first time – or if it has been longer than three years since you saw her last.
When you are going to be seeing one of our plastic surgeons for the first time – or if it has been longer than three years since you last saw one of them – to discuss a cosmetic procedure that is not paid for by insurance companies. (Examples include breast augmentation, tummy tuck, etc.)
When you are going to be seeing one of our plastic surgeons for the first time – or if it has been longer than three years since you last saw one of them – to discuss a procedure that will be billed to your insurance company. (Examples include breast reduction, breast reconstruction, lesion removal, hand surgery, etc.)
Northland Plastic Surgery uses a tablet based registration process called Phreesia which allows patients to electronically enter their information. Please arrive 20 minutes in advance of your appointment to register. New patients for our Skin Care Center will still register by printing and completing the forms above.
Download and print if you need a copy of your medical records from us, please print out and mail in this form.
Call us with your requests and any additional questions at (218) 724-7363 or (800) 964-6891