AestheticProcedures Botox® Daxxify™ Redensity Fillers RHA Fillers Belotero Balance® Juvéderm® Restylane ® Radiesse® Volbella Under Eye Fillers Kybella Earlobe Repair Microneedling Microneedling w/ PRP Spider Vein Treatment PRP for Hair Loss Laser SkinCareTreatments TotalSkin Solution™ Genius™ KeraLase™ LaseMD ™ VBeam® Perfecta Dermatology &Skin Surgery Skin Exam Excessive Sweating / Hyperhidrosis treatment Psoriasis Rosacea Treatments Hair Loss Treatments Skin Cancer Acne DermTech smart sticker mole evaluation Melasma Treatment Earlobe Repair Skin Growth Removal Skin Discoloration Skin Care & Aesthetician Services Cosmetic Consult Microneedling Hydrafacial Treatment Microneedling + PRP Microdermabrasion Chemical Peels Dermaplaning Clinical Trials Current Trials Trial Ethics Blog In the News Television Articles Podcasts Specials Monthly Highlights VIP Membership Alle Rewards Program Forms Patient Forms Authorization for Release of Medical Information Authorization and Consent for Treatment (Autorización y Consentiemento Para el Tratamiento) Preferred Contacts (Contactos Preferidos) Office Policies Financial Policy Notice of Privacy Practices HIPAA Privacy Notice If you are human, leave this field blank.This form is for patients only. No solicitation permitted.CONTACT INFORMATIONName *Email *PhoneAdditional comments or questionsSUBMIT APPOINTMENT REQUEST