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239-243-8222 Fort Myers/Cape Coral/Naples/Estero

12650 World Plaza Ln. Building 72 Ste. 1, Fort Myers FL 33907

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patient information form

U First Health Laser & Rejuvenation Center has a mission to make patient satisfaction a priority amongst your healthcare needs. Our goal is to educate you, as the patient, while combining the utmost in quality of care with open communication. Together, we will work towards ideal clinical outcomes and an overall healthier, rejuvenated lifestyle for you.

 

We are husband and wife that are board certified physicians practicing in the specialties of general surgery and gynecology/cosmetogynecology, respectively. We have obtained certification in SmartLipo and other cosmetic surgeries and are very proud to bring these procedures to southwest Florida. We have provided a pleasant atmosphere along with our highly trained and compassionate staff to make your experience as comfortable as possible. We have two AAAASF certified operating rooms for your convenience, privacy and safety. Our one price surgical quotes for all cosmetic procedures gives you satisfaction in knowing there are no other hidden fees.

Patient Information

You can either fill out these PDFs (get Adobe Acrobat) and save to your computer, then attach the forms and send them in an email addressed to info@ufirsthealth.com; or you can print, fill out and fax them back to us at 239-236-1595.

 

New Patient Registration Forms

Authorization for Release of Medical Records

Notice of Privacy Practice

 

If you have any questions about any of this material, please contact us by email at info@ufirsthealth.com; or call us at 239-243-8222.

 

PLEASE ARRIVE 15 MINUTES PRIOR TO YOUR SCHEDULED APPOINTMENT TIME.  PLEASE DO NOT FORGET TO BRING YOUR PHOTO ID AND INSURANCE CARD(S). REMEMBER TO COMPLETE THE FORMS AND SUBMIT 24 TO 48 HOURS PRIOR TO THE APPOINTMENT.

********PLEASE NOTE THIS WILL SIGNIFICANTLY DECREASE YOUR APPOINTMENT WAITING TIME!********

 

See our Cancellation / No Show Policy

 

Please remember to call your referring physician and have them fax records to our office 24 to 48 hours prior to your appointment. Our fax number is 1-239-236-1595.

Ft Myers Medi-Spa | U First Health

Medical Spa | Body Sculpting & Aesthetic Procedures in Ft Myers, Naples, Cape Coral, Florida

 

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