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Medical Record Update for Cosmetic Services

No Changes

Medical History Questionnaire Cosmetic Services

All questions contained in this questionnaire are strictly confidential and will become part of your medical record. All questions must be answered.

Failure to do so will result in an inaccurate medical record. PLEASE ASK if you have any questions.

Name
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Thank you for providing this important information about your medical history. Please be advised that completing preliminary health and insurance questionnaires does not establish a physician-patient relationship with this practice. Dr. Aggarwal will review your health history and conduct an initial evaluation to determine whether you are a suitable candidate and whether the practice will accept you as a patient.

By typing out your name you are accepting this as your signature
By typing out your name you are accepting this as your signature
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Professional Skin and Beauty Care at Our Aesthetic Treatment Center

Aesthetic Care Center, our specialized aesthetic treatment facility led by Dr. Aggarwal, combines advanced anti-aging technologies with personalized treatment plans to address your unique skin concerns. Our comprehensive suite of medical-grade aesthetic services includes the latest innovations in skin rejuvenation and body contouring, such as Botox, RF microneedling and truSculpt, all delivered with the same expertise and attention to detail that defines our vein care practice. Begin your transformation with a complimentary skin care screening, where we’ll create a customized plan to help you achieve your aesthetic goals.

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