subpage header image

patient forms

plastic surgery

You can make your visit to Dr. Simon's office more convenient. Please click below to download patient forms in Adobe PDF format. These forms may then be printed, filled out at home, and brought into our office on your next appointment.

ALL THE FORMS IN ONE FILE:
> Patient Forms Package

INDIVIDUAL FORMS:
> Patient Information
> History & Physical
> Notice of Privacy Practices
> Disclaimer
> Arbitration Agreement
> Photo Release


To make an appointment, call 305 668 0496.