Patient Forms

Please download, fill out, save, and print these forms and bring them with you to your first visit to Laser Skin Care Center or email the completed forms (please be sure to save the filled out forms to your computer prior to sending) as an attachment to [email protected]:

*Please complete Care Credit application for 12 month, no interest financing or 24/36/48 months with interest financing. The 12 month program has a $300 minimum charge with the other programs having a $1,000 minimum charge.

Patients Requesting Medical Records

If you are our patient and would like to request your medical records, please click on the link below to complete your request for medical records. You will be required to provide a valid email address and a government-issued ID.

Third-Party Requestors for Medical Records

If you are an attorney, insurance company, or any other entity requesting records from our facility, please click on the link below to upload your request along with the patient’s authorization.