• home
  • about
    • About Dr. Farahmand
    • Choosing a Plastic Surgeon
    • Patient Forms
    • Plastic Surgery Seminars
  • procedures
    • body
    • Liposuction
    • Tummy Tuck
    • breast
    • Adjustable Breast Augmentation
    • Breast Augmentation
    • Breast Lift
    • Breast Reduction
    • face
    • Botox®
    • Browlift
    • Chemical Peel
    • Dermabrasion
    • Dysport™
    • Ear Surgery
    • Eyelid Surgery
    • Facelift / Necklift
    • JUVEDERM® Injectable Gel
    • LATISSE®
    • Perlane®
    • Radiesse®
    • Restylane®
    • Rhinoplasty
  • photos
    • body
    • Liposuction
    • Tummy Tuck
    • breast
    • Adjustable breast Augmentation
    • Breast Augmentation
    • Breast Lift
    • Breast Reduction
    • face
    • Browlift
    • Dermabrasion
    • Eyelid Surgery
    • Facelift / Necklift
  • travel
  • financing
    • What does it cost?
    • Financing Options
  • contact
    • Contact Information
    • Office Location & Directions
    • Patient Forms

Patient Forms

Patient Registration Forms:
All new patients please click here to view and print all registration forms.

Or, access an individual form below:
Consent for Purpose of Treatment
Consent to Disclose Medical Information
Authorization for Disclosure of Information
Cosmetic Financial Policy
Directions to Office
Health History
Patient Privacy Notice
Patient Registration
Photographic Consent

Pre-Operative Paperwork:
Drugs to avoid prior to surgery
Miscellaneous Operative Consent

Armlift Consent
Belt Lipectomy Consent
Blepharoplasty
Breast Augmentation
Browlift
Dermabrasion
Facelift Consent
Mastopexy Consent
Rhinoplasty Consent
Thigh Lift Consent

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  • Procedures

    • Body
      • Liposuction
      • Male Breast Reduction
      • Tummy Tuck
    • Breast
      • Adjustable Breast Augmentation
      • Breast Augmentation
      • Breast Lift
      • Breast Reduction
    • Face
      • BOTOX®
      • Browlift
      • Chemical Peel
      • Dermabrasion
      • Dysport™
      • Ear Surgery
      • Eyelid Surgery
      • Facelift / Necklift
      • JUVÈDERM® Injectable Gel
      • LATISSE®
      • Perlane®
      • Radiesse®
      • Restylane®
      • Rhinoplasty
    • Uncategorized
  • Resources

    • Allergan
    • American Society of Plastic Surgeons
    • Beauty for Life
    • Bioform Medical
    • Bonita Community Health Center
    • BOTOX® Cosmetic
    • Cape Coral Hospital
    • Cape Coral Surgery Center
    • CareCredit
    • Chase Health Advance
    • Dysport™
    • Gulf Coast Hospital
    • HealthPark Medical Center
    • Juvéderm®
    • LaRoche Posay
    • Latisse®
    • Lee Memorial Hospital
    • Mayo Clinic
    • Medicis Aesthetics
    • Mentor Corporation
    • Perlane®
    • Radiesse®
    • Restylane®
    • Skin Ceuticals®

Farahmand Plastic Surgery • 13710 Metropolis Avenue • Fort Myers, FL 33912 • 239.332.2388

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