Online Forms
Plastic Surgery | ENT | Allergy | Registration Form | Survey Forms
Plastic Surgery:
Please fill out all 6 new patient forms if you are scheduled for a consultation with Dr. Rubinstein or already have your treatment scheduled and are a new patient with our office. If it has been 1 year or more since your last visit to our office we may ask you to complete new forms so that we may update your information.
Patient Registration
Health Information
Insurance Information
Photo Authorization
HIPPA Authorization for disclosure of Medical Information*
Cancelation Policy
Pre-Op Instructions:
The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.
Pre-op Instructions :
It is very important that you review your Pre Op documents before your Pre Op appointment. Please bring all forms with you to your appointment.
Blepharoplasty Pre Op
Cheek Implant Pre Op
Chin Augmentation Pre Op
Face Lift Pre Op
Fat Transfer Pre Op
Laser Resurfacing Pre Op
Lesion/Cyst/Nevus/Skin Tag Pre Op
Otoplasty Pre Op
Rhinoplasty Pre Op
Medi-Spa Services:
Pre Botox & Fillers
It is very important that you review your Post Op documents before your Pre Op appointment. Please bring all forms with you to your appointment.
Blepharoplasty Post Op
Browlift Post Op
Cheek Implant Post Op
Chin Augmentation Post Op
Earlobe Repair Post Op
Face Lift Post Op
Facial Liposuction Post Op
Fat Transfer Post Op
Laser Resurfacing Post Op
Lesion/Cyst/Nevus/Skin Tag Removal Post Op
Liposuction Post Op
Otoplasty Post Op
Rhinoplasty Post Op
Medi-Spa Services:
Post Botox & Fillers
Laser Treatment of Leg Veins Post Op
Pre-op Injections :
Please read the following documents pertaining to all injections offered at Laser & Cosmetic Surgery Specialists, PC. It is very important to review all Medications to avoid before your appointment. It is necessary to avoid all medications listed one week prior to your appointment.
Definitions & Terms
Consent - The Pills I Take
Medications to Avoid
Consent for Treatment
ENT
Allergy
Survey Forms:
Feedback from our patients is very important. Please take the time to complete our survey. If you have had a consulation and are thinking about having a procedure please select our Post Consult Form. If you have had treatments or surgery with us, please complete the Post Treatment or Post Surgery Form. Again, we thank you for taking the time to let us know what you think.
Post Consult Survey
Post Treatment Survey
Post Surgery Survey