the MedSpa patient forms

Please be sure to arrive at least 15 minutes prior to your scheduled appointment time
to complete all necessary paperwork.

The following forms are available to you for your convenience (please note the items with * are needed for initial consultation):

Clear + Brilliant™ Consent

Laser Hair Removal

Media Disclosure Authorization

YAG and IPL Consent

ResurFX Consent

ThermiSmooth Treatment Consent

Tripollar Consent

Voluderm Consent

Prior to your appointment, you may download the New Patient/Info Consent form and email the completed document to .

In order to provide our patients with the best medical care and most appropriate treatment plan, we require all of our patients to complete a new health history form on an annual basis.

Please Note: These files are in PDF format.

>> Download Adobe Acrobat Reader

Schedule your complimentary consultation with one of our highly educated professionals to discuss your skin concerns and develop a treatment plan consisting of in-­office services and products to achieve your desired results.

The Medspa Raleigh - Best Med Spa Raleigh

Get a complimentary consultation with Dr. Adam Purzycki,
Board Certified Plastic Surgeon!

Join the Family!

and save 15% off your
first treatment!

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