Patient Forms

Save Time in Our Office Completing Forms

The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time you will save significant time at the time of your visit. If you have any questions when filling out these forms, please do the best you can, our staff will assist you with your questions on the day of your visit.

  • Please do not mail the completed forms to the office.
  • Please bring them with you at the time of your scheduled visit.

We now have the ability for you to go online to our patient portal and enter your medical history directly into our electronic medical record system. Please call our office at 631.689.1100. Our reception service specialists will assist you in logging into our portal.

If you would rather download the forms and fill them out at home, please print out and fill out the following form:

Patient Information Packet

Note: This files are in PDF format. If you do not have Adobe® Reader® on your computer, you can download it for free by clicking here or on the Get Adobe Reader icon.

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MEMBER OF AMERICAN
BOARD OF PLASTIC SURGEONS

MEMBER OF AMERICAN SOCIETY
FOR AESTHETIC PLASTIC SURGERY

ACCREDITED BY THE
JOINT COMMISION

AMERICAN BOARD OF PLASTIC
SURGERY CERTIFICATION



NEW PATIENT CONSULTATIONS, INJECTABLES,
NON-SURGICAL PROCEDURES AND POST-OP CARE
Epstein Plastic Surgery
2500 Nesconset Hwy, #8A
Stony Brook, NY 11790