We have MOVED to 4316 Rice Lake Rd, Ste 109, Duluth MN 55811

Cosmetic Services Patient Forms

Northland Plastic Surgery uses a tablet based registration process called Phreesia, which allows patients to fill out their information electronically in our office. Please arrive 20 minutes before your appointment to register, unless you pre-registered from the link in the text or email we sent prior to your appointment. 

Below you will find several forms we will need for registration. Please take a few minutes to print them out and complete them if you prefer not to pre-register or use the Phreesia tablet. 

Welcome
Form
HIPAA
Notice
Authorization to
Release Information
Patient Notices and Authorizations
Permission to Discuss Health

Payment for services and products will be collected at the time of the appointment. We accept Visa, MasterCard, American Express and Discover. See our payment options for more information.