Patient Forms

Please download as a PDF file, fill out the requested form and bring it to your appointment. You may also fax them to us:

Patient Registration Forms

• Print – New Patient Forms
• Digital – New Patient Forms

• Print – Consent To Treating a Minor
• Digital – Consent To Treating a Minor

• Print – Request For Health Information
• Digital – Request For Health Information

Surgery Forms & Care Instructions

• Surgical Patient Questionnaire
• Patient Medication
• Acknowledgement Of Patient Rights
• Rescheduling & Cancellation Policy
• Pre & Post Care For Chemical Face Peel
• Pre & Post Care For Total (Active/Deep) FX Laser Resurfacing

Post Treatment Instructions

• Fraxel Laser Resurfacing
• Biopsies -Coming soon
• Filler -Coming soon
• Botox -Coming soon
• Compresses
• Liquid Nitrogen Therapy
• Wart Therapy

Medication Instructions

• Tretinoin / Retin-A
• HQRA (Bleaching Cream)

At American Skin Institute of Los Angeles, we're proud to offer Patient Forms to the Los Angeles area and across Southern California. With three locations in Sherman Oaks, Beverly Hills, and Westlake Village, we are easily accessible to residents throughout the San Fernando Valley and surrounding areas for Patient Forms, including: Agoura, Brentwood, Burbank, Calabasas, Camarillo, Chatsworth, Encino, Glendale, Granada Hills, Hollywood, Los Angeles, Mission Hills, Moorpark, North Hollywood, Simi Valley, Tarzana, Thousand Oaks, Valley Glen, Westwood, Woodland Hills