We look forward to welcoming you to Harbor Plastic Surgery Center. Health Care regulations require all patients to complete a New Patient Packet prior to being seen by a physician. This includes patients who are coming for a complimentary consult. We appreciate your effort in completing these forms as thoroughly as possible.
To expedite the check-in process, it is recommended that you complete the New Patient Packet prior to your scheduled appointment time. Should you prefer to complete all documentation on the day of your appointment, please plan to arrive 15 minutes early.
At all times you will be treated as an integral partner in your treatment and will be respected by our physicians and staff. At any point in the process should you feel your patient rights have been violated, we ask that you notify management immediately. In return, it is your responsibility to be fully engaged in your treatment plan and communicate effectively with your treatment team. Open and honest communication with Dr. Piasecki and our staff is an integral part of the process. Please review the Patient Rights and Responsibilities document carefully prior to signing.
If you live outside of the area and are interested in a no cost, no obligation email consultation with Dr. Piasecki, please complete the Out of Area Consult form and fax it to Harbor Plastic Surgery Center 888.843.2412.
The Health Insurance Portability and Accountability Act (HIPAA) requires patient’s consent before your personal medical records can be shared. The Medical Records Disclosure Form should be completed and sent to your current health care provider authorizing them to share your records with Harbor Plastic Surgery Center.