For your convenience, we have made our patient forms available for download. If you wish, you may complete the forms prior to your initial appointment and bring them with you to your appointment.
All forms below are required for your appointment.
PATIENT FORMS:
HIPPA POLICY:
Medical Record Release
Please be advised that Atlanta Plastic & Reconstructive Specialists charges a $25.00 fee for patient requests for medical records, unless they are being sent to another medical facility. Payment is due before any documents are released. Please note that it takes approximately 7 – 10 business days to process medical records requests.
To have a copy of your medical records sent to another facility or to obtain a copy for personal purposes, please complete the following steps.
Family and Medical Leave Act (FMLA)
Our policy regarding Family and Medical Leave Act (FMLA) and Disability forms must be completed by our nurse, which requires a fee. Please be aware of these fees, as they are not covered by health insurance and are solely the responsibility of the patient.
Please allow 7 – 10 business days for completion
– One Page – $10.00
– Two or more pages – $25.00
For easy viewing and printing, Patient Forms are presented in Adobe format (.pdf). For a free copy of this program, click here and follow the instructions.
If your insurance doesn’t cover all the costs for the procedure you want and need, where do you turn? CareCredit, a GE Money Company, gives you convenient payment options so you can get the procedure you want, when you want it.
You can apply over the phone by calling (800) 677-0718 between 5:00 a.m – 7:00 p.m or online by visiting:
Why Choose Atlanta Plastic & Reconstructive Specialists
Atlanta Plastic & Reconstructive Specialists provides expert cosmetic and reconstructive care, focusing on safety, precision, and natural results. Here’s what sets them apart.
Atlanta Plastic & Reconstructive Specialists combines medical excellence with artistic precision to help every patient look and feel their best.
Schedule a Consultation
Ready to rejuvenate your skin and restore your confidence?
Contact Atlanta Plastic & Reconstructive Specialists to schedule your consultation at our Alpharetta office (404) 255-2975 or Buckhead office (404) 343-0897 today.