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Patient Forms
There are several pages to each packet. Please select the packet that corresponds with your appointment type.
Aesthetic Patient Registration Forms
Medical History
Medical Patient Registration Forms
These forms are in Adobe (PDF) format and require Adobe reader. This is a free download from Adobe. If you need Adobe reader follow the Adobe link.

You must be in good health to undergo any elective cosmetic surgery. Our office will do a screening EKG and have you do routine lab work. At times, we require medical clearance from your own primary physician. We require pre-op paperwork be completed and returned to our office at least 1-2 weeks prior to surgery. It is of the utmost importance that our office be aware of any medical conditions that you have and all medications that you are taking.
Several weeks before your surgery, Dr. Kaplan will ask you to refrain from several things that will prevent good healing and/or slow down your recovery process. They are all important instructions and must be followed. If you do not think you will be able to abide by these, you may want to consider a non-surgical option.
- Stop smoking. It is well proven that smoking slows/impedes healing by reducing circulation to the skin. Stop smoking now to avoid this.
- Stop drinking alcohol 5 days prior to your surgery to avoid the damaging effects of alcohol to the blood vessels and the increased risk of post-operative bleeding.
- Stop taking any drugs that contain Aspirin or Ibuprofen for two weeks prior to surgery. They can cause bleeding during and after surgery. Our office will provide you with a list of drugs containing these ingredients so that you can avoid using them.
- You may use acetaminophen (Tylenol).
- Take no more than one multi-vitamin daily. Discontinue all others for 2 weeks prior to your surgery.
- Please make arrangements to have someone drive you to our office and pick you up to drive you home on the morning of your surgery. The law requires that someone must drive you home upon your discharge.
- Our office will call you to confirm your arrival time for your surgery. It is important that you give our office a number where you can be reached after 5pm. If you are having Monitored Anesthesia Care, our anesthesiologist will also call you on the number you provide to us.
- If you are not going to be home or at work – please call our office at (888) 968-0038 to give us the number where you can be reached after 5pm.
- Do not eat or drink anything after midnight the night before your surgery. This includes water.
- Do not eat or drink anything!
- If you take prescription medication, discuss this with Dr. Kaplan at your pre-operative appointment. If you are directed to take it, you will do so very early in the morning with only a sip of water.
- Please shower and wash your hair and cleanse the surgical area thoroughly with soap and water.
- Please brush your teeth but do NOT swallow the water.
- Do not wear make-up, moisturizers, creams, lotions, cologne or aftershave.
- Clothing should be comfortable and loose-fitting with buttons or a zipper in front so that you won’t have to pull the top over your head. Wear slide-on shoes and bring or wear socks. Remove hairpins, wigs, jewelry and do not bring valuables with you.
- Check-In – report to our surgical suite as indicated on your instructions.
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