New Patient Forms

You can complete an electronic copy of the registration forms using Adobe Acrobat Reader.

Please contact us at (860) 409-1515 if you have any questions.

Patient Medical History Form

Stanislaw-Medical-History-Questionairre-REV-250602Download

New Patient Registration Form

Stanislaw-New-Patient-Packet-REV250602Download

Rewards Program

We offer rewards with Aspire and Allē. You can sign up for both rewards programs ahead of your appointment to start earning at your first visit. View our rewards page to learn more!

Consultation Fees

  • Routine Cosmetic Consultation with doctor $150
  • Rhinoplasty Consultation with doctor: $250
  • Problem Cosmetic Consultation with doctor $500

*Consultation fees are not applicable toward any procedures

Privacy Policy

privacy-policyDownload