top of page

Patient Paperwork

Prior to any Plastic Surgery or Skin Care Services our office needs completed patient forms. 

 

Click on the PDF next to the paperwork you've been asked to complete by our staff.  Please print, fill out completely and bring it with you to your next appointment. If you need assistance, please contact our office. 970-242-9127

If you are a patient seeing Dr. Merkel or one of our aestheticians, please complete forms 1, 2 and 3.

​

1) Patient Confidential Information

2. Confidential Medical History

3.  Medication Record

Request an appointment at the clinic for breast augmentation, skin care, stem cell injections, laser hair removal, or any other plastic surgery needs.

bottom of page