Patient Forms

Our practice treats cosmetic patients, hand and reconstructive patients, and patients suffering from severe migraines. Review the section that applies to you.

Cosmetic patients:

Your patient information and past medical history forms can be filled out online. Click here to access them. After you fill out the information you will be directed to a form for you to print and sign that acknowledges how your personal health information will be handled. Lastly there is a signature form that acknowledges you are aware of our privacy policy. The privacy policy can be read here. Please print and bring the signature forms with you to the office. Don't worry if you forget, you can also sign when you arrive at the office.

Reconstructive and Hand patients:

Please read the privacy policy first. (Yes, its just like all of the others.) Then fill out the reconstructive and hand surgery information online here. You will enter your basic information, insurance information, and medical history. When you are finished you will be directed to a form you can print, sign, and bring in to the office that acknowledges how your personal health information will be handled. There is also signature form that acknowledges you are aware of our privacy policy.

Migraine patients:

If you have not done so, review the migraine surgery page first. You can also follow the steps here. Make sure you review the privacy policy too.

  • Call for Appointment

    First, call the office to schedule your appointment. Click to schedule your consultation or call us at: 770 682-3375. That gives you a chance to ask questions and lets us explain the process to you before your visit.

  • Download and Log

    Download and fill out the migraine logs for 4 weeks. This log helps you begin to really focus where the migraine pain starts from. You will need to identify where the pain begins and where the pain travels. The symptoms you experience and the environmental conditions on the day you have the migraine headaches are very important in order to see the overall picture about your headaches. You may even begin to see a pattern about your headaches that you did not realize before. The migraine logs can be downloaded here.

  • Pre-Treatment Form

    Fill out the Pre-Treatment form. Use the pre-treatment form to provide additional information that you could not put on the migraine log. You may also write any additional comments on a separate piece of paper. The pre-treatment form can be downloaded here.

  • Functional Nose Form

    Fill out the Functional Nose form. Please pay attention to the questions asked. For example, you may not have noticed that you breathe through your mouth instead of your nose. Your family members can help you by watching your daily functions. Download the functional nose form here.

  • History and Physical Information

    Lastly, the history and physical information needs to be filled out. This can be done online through this link. Please be thorough with your answers.