medical
 

Once all forms are complete and signed, you may fax them to us at 312-260-9096, mail them to us at least 1 week in advance, or bring them with you to your appointment.

You will need Adobe Reader to be able to download, read and print the forms. If you do not already have this program, you can download it for free at http://www.adobe.com, click on adobe reader to download.

Latisse
New Customer Latisse Consent Form-
Please print and fax to 312.260.9096

Laser Hair Removal Patient
Laser Hair Removal Forms

Botox Patients
Dermatology Patients
 
 
 
*Please read through our Notice of Privacy Practices before signing.
 
If you have any questions, please call us at (312) 260-9020.