Patient Forms

Walk-in visit Visita sin cita (Walk-in visit, Spanish) Consent to treat Consentimiento para recibir tratamiento (Consent to treat, Spanish) Privacy notice Aviso de prácticas de privacidad (Privacy notice, Spanish)

New member health history Membership agreement MO HealthNet private-pay agreement

Hormone therapy questions Hormone therapy consent Weight management questions Weight management consent IV and injection questions IV and injection consent Peptide therapy consent Off-label use of ivermectin Controlled substance agreement

Botox questions Botox consent Filler questions Filler consent

General procedure consent Wound closure Incision and drainage Joint or soft-tissue injection Skin biopsy Skin lesion removal (freezing or cautery) PRP injection Men's PRP injection TED hair restoration

Request for medical records Authorization to release medical records Telehealth consent Photo and social media consent Depression screening (PHQ-9)