New Patient Paperwork

Please print and fill out all forms and bring them to the office with you at the time of your appointment.

How did you find out about us?
Medical History
New Patient Registration
Notice of Privacy Practices
Notice of Privacy Practices - Consent Form
Release of Medical Records

Consent Forms and Pre-Op Instructions

Please select the correct procedure link, print, and fill out all forms.
Email signed consents to qnacosmeticsurgery@gmail.com or fax to (985) 386-2698.

Cellulaze Forms

CO2 Laser Forms

Eyelid Surgery Forms

Laser Lipo Forms

Neck Suspension Forms

NeoGraft Forms

Pearl Fractional Forms

Scar Revision Forms

Smartlipo Forms

TCA Forms

*Individual results may vary. Photography contains a mix of actual patients and stock photography. Testimonials are from actual patients.