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FORMS – please choose a form below to download a pdf

Dr. Rochlin Intake Form

Dr. Rochlin Medical History Form

Lip Implant Consent Form

Lip Implant Pre and Post Instructions

Pre-Operative Instructions

Post-Operative Foods to Avoid

Bedside Items Needed

Abdominoplasty Consent

Abdominoplasty Post Instructions

Breast Augmentation Surgery Consent

Post Op Breast Augmentation Surgery One Day

Dermal Filler Consent

Dermal Filler Treatment Info and Post Treatment Instructions

Consent for HIV Testing

Consent for Anesthesia Services

Pre-Anesthesia Patient Questionnaire

Liposuction Consent Form

Pre-Operative Liposuction

Post Op Liposuction

Blepharoplasty Consent

Blepharoplasty Post Op Instructions

Botox Consent

Botox Post Treatment Instructions

Scar Revision Consent

Scar Reduction Recommendation

Photo Consent

Medication Information

Latisse

Acyclovir / Zovirax / Acycloguanosine

Ciprofloxacin / Cipro / Cipro XR / Proquin XR

Cephalexin / Keflex

Cyclobenzaprine / Flexeril

Hydrocodone / Dihydrocodeinone

Diazepam / Intensol / Valium

Promethazine / Phenergan / Promacot / Promethegan

Propoxyphene / Darvon / Darvocet

  
Scottsdale Office: 11000 North Scottsdale Road Suite 235 Scottsdale, AZ 85254 | Gilbert Office: 633 East Ray Rd Suite 110 Gilbert, AZ 85296
Dr. Semone Rochlin D.O. Copyright © 2010