Patient Forms

Patient forms download

Patient Forms And Instructions

We recognize that your time is just as valuable as ours. For that reason, we ask that you take a moment before your first visit to complete the online registration process. It’s short and simple, and it will help us keep your appointment on time.

To help you prepare for your consultation, we’ve provided some of our patient forms. The forms are intended to be printed out and brought back to the office for your appointment, or mailed back prior to your appointment.

 

If you have any questions or would like assistance with these forms, please call us at (514) 742-9563.

PATIENT FORMS  (pdf/download)

  • New Patient History and Medical Information Form

 

SURGERY FORMS (pdf/download)

  • Registration Form
  • Photo Authorization – Surgical

 

OTHER FORMS (pdf/download)

  • Release of Records Form

 

Create the look you've always wanted for yourself.

We believe plastic surgery can achieve beautiful yet subtle results that accentuate your natural contours.

Schedule a consultation today to learn how Dr. Arash Izadpanah can empower you to take control of your look.

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