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Chicago Cosmetic Surgery & Dermatology

Forms & Policies

To help your visit run smoothly, we’ve made important forms and policies available in the Patient Portal and online. From registration and consent documents to our financial and privacy policies, you can review and complete everything ahead of time—saving you time at check-in and ensuring you’re fully prepared for your appointment.

Registration

Our registration form helps us gather your essential personal and contact information prior to your visit. Completing this form ensures a seamless check-in experience and allows our team to focus on what matters most—your care and comfort.

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Financial Policy

We believe in transparency. Our financial policy outlines billing procedures, payment expectations, and insurance information so that you feel fully informed before beginning treatment. By reviewing this policy, you’ll know exactly what to expect when it comes to managing the financial side of your care.

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Privacy Practices

Your trust and confidentiality are our top priorities. This document explains how we protect your personal health information in compliance with HIPAA regulations. It also details your rights as a patient, giving you peace of mind that your privacy is always respe

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Photo Consent

Medical photography is an important part of documenting your treatment journey. With your consent, we may use photographs for your medical records, to monitor progress, or—with permission—for educational or marketing purposes. This form ensures you have full control over how your images are used.

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Medical History

Your safety and results depend on a complete understanding of your health background. The medical history form provides our team with important details about your current health, past conditions, medications, and allergies. This helps us design the safest, most effective treatment plan tailored to your needs.

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Minor Treatments

This form is required for patients under the age of 18 and ensures that a parent or legal guardian has authorized their child’s medical or cosmetic treatment. It helps us provide safe, appropriate care while protecting the rights of both the patient and their guardian.

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FAQ's for Forms & Policies

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