Patient Forms and Instructions

Myers_Pic_FormsPlease complete these forms, print and sign them and bring them with you to the office when you arrive for your consultation. This will help Dr. Myers look at your entire health history as he discusses the best options for you.

Click on each form below. It will open in a new window where you can type your answers then print the completed form. Or you can print the blank form and write in your responses.

NEW PATIENT FORMS

NEW PATIENT INFORMATION FORMS

PRE BREAST OPERATION FORMS

BREAST REDUCTION QUESTIONNAIRE

POST BREAST OPERATION CARE

BREAST AUGMENTATION POST-OPERATIVE INSTRUCTIONS

BREAST LIFT POST-OPERATIVE INSTRUCTIONS

BREAST REDUCTION POST-OPERATIVE INSTRUCTIONS

POST BODY OPERATION CARE

ABDOMINOPLASTY POST-OPERATIVE INSTRUCTIONS

LIPOSUCTION POST-OPERATIVE INSTRUCTIONS

POST FACE OPERATION CARE

OTOPLASTY (EAR PINNING) POST-OPERATIVE INSTRUCTIONS

BLEPHAROPLASTY POST-OPERATIVE INSTRUCTIONS

BOTOX® POST-INJECTION INSTRUCTIONS

GENERAL POST OPERATION CARE

DRAIN CARE INSTRUCTIONS

DRAIN RECORD

DRUGS THAT MAY CAUSE BLEEDING

SKIN CANCER/LESION REMOVAL POST-OPERATIVE INSTRUCTIONS

PATIENT CONFIDENTIALITY FORMS

HIPPA AUTHORIZATION FORM

HIPPA MINOR AUTHORIZATION FORM

PHOTO RELEASE FORM

PRIVACY PRACTICES