PATIENT FORMS
For your convenience, the patient registration and medical history forms are being made available for download. If you prefer to print and complete the forms prior to your visit to Plastic Surgical Center, you are welcome to do so.

DOWNLOAD FORMS
Patient Registration
To expedite our check-in process, please download, print, and complete the Patient Registration form. Upon completing the form, please bring it to your initial appointment.

Click here to download the Patient Registration form.

Patient Medical History
To give our medical staff an understand of your past and current medical health status, please download, print, and complete the Patient Medical History form. Upon completing the form, please bring it to your initial appointment.

Click here to download the Patient Medical History form.

PLASTIC SURGICAL CENTER
Registration Process Questions?
Do you have questions about the patient registration process? Need help understanding and completing the Patient Registration and/or Patient Medical History forms? Click here to contact us today.

Personalized Service ... Specializing in You










Patient Testimonials
I had a facelift and my eyes done by Dr. Black right before my 20th high school reunion. I loved the result and everyone said I hadn't aged a bit!! Dr. Black and his staff took excellent care of me and I would not hesitate to refer my friends to him.

Dee ... age 41
Copyright © 2011  •  Steven B. Black M.D.  •  Plastic Surgical Center, P.C.  •  All rights reserved.
2727 South 144th Street  •  Suite 285  •  Omaha, Nebraska 68144  •  402.778.5252  •  Contact Us