Palms Wellington Plastic Surgery

Plastic Surgeon West Palm Beach - Dr. Itzhak Nir

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Call us561-753-3331
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      • Facelift and Neck Lift
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      • Other Injectables
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Patient Forms

If you are a new patient to our office, the attached file contains our new patient bundle with forms that will need to be filled out when you arrive at our office. Printing them, filling them out and bringing them with you will allow us to attend to your needs more quickly than completing them on your arrival. Thank you and please call our Palms Wellington Surgical Center office if you have any questions at all.

Patient Registration Forms:

Click on the forms below to open. Print and complete as much as possible and bring the completed forms with you to your appointment or fax to (561) 753-3823.

  • Patient Medical History

  • Hippa Patient Form

  • Photo Consent

Request an Appointment

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Palms Wellington Plastic Surgery - Dr. Itzhak Nir

Address

Palms Wellington Plastic Surgery
13005 Southern Blvd. Suite 232
Wellington, FL 33470

Office: (561) 753-3331
Fax: (561) 753-3823
(Building 2 on Palms West Hospital Campus)

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