Patient Forms


Get ahead of the game and reduce waiting time.

rps NEW PATIENT FORM

Your comfort and satisfaction is our goal; we pride ourselves in educating guests. To best achieve this we would like to know about you and your lifestyle. Required for new patients.

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RPS HIPAA

A statement regarding the Health Insurance Portability & Accountability Act of 1996. Required for new patients.

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rps questionnaire

Information about your referral source and goals. Required for new patients.

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CREDIT CARD AUTHORIZATION FORM

Authorize Spa Renaissance & Renaissance Plastic Surgery to make a one-time transaction to your credit or debit card.

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INFORMED CONSENT forms

For your convenience, below is a list of various downloadable Informed Consent forms.

 

Pre / Post Operative Instructions

For your convenience, below is a list of various downloadable Pre/Post Operative Instructions.