Forms

When you arrive at the U-M Center for Facial Cosmetic Surgery for your consultation, you will need to complete our Health History Questionnaire. You may also need to complete an Authorization to Release Copies of a Medical Record. For your convenience, you can download these forms here, and fill them out prior to your visit. If you choose to download, print and complete the forms in advance, please bring them with you to your consultation appointment.

Health History Questionnaire

Authorization to Release Copies of a Medical Record