There are many advantages to use online registration form.
You are completely informed after online registration.
It will save your time on the day of your consultation and/or procedure.
You are able to provide the accurate information in the privacy of your own home or office.
We are able to review your history before you arrive and to call you if there are any medical or social concerns.
This site is secure and your information is kept confidential. This registration form must be completed by the patient only.
To schedule a surgical procedure, a non-refundable and non-transferable deposit, $420 for self pay patients and $100 for insured patients, is required of all patients. We accept Visa or MasterCard credit/debit card only. This is credited toward your actual surgery cost. If you cancel or re-schedule for any reason, your deposit will not be refunded, and you have to pay new same deposit if you re-schedule your surgical appointment.
Fill in the OnlineRegistration and Deposit Form and click "Submit". Fields marked * are Required Fields.
After registering, we will call you within 2 business days of receiving your registration.