Patient Resources

Patient Forms

As a convenience for our patients, and to save you time on your first visit, you can print the following forms, fill them in, and bring them with you. 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.

Salem Plastic Surgery | Patient Resources | Winston Salem NC | Greensboro NCNote: These 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.

Payment Options

The Aesthetic Center Plastic Surgery & Medical Spa proudly accepts the following forms of payment:

  • Cash
  • Check
  • Visa
  • MasterCard
  • American Express
  • Discover
  • CareCredit

Financing

We believe that reaching your aesthetic goals shouldn’t put a strain on your finances. Our office accepts cash, check and all major credits cards and we will be happy to work with you to help you finance your procedure, if that’s what you need to make it happen. Also some procedures if medically necessary, may be covered entirely or in part by your medical insurance.

As a service to our patients we are pleased to offer CareCredit, the nation’s leading patient payment program. Upon request and approval, CareCredit offers a comprehensive range of plans with low minimum monthly payments that fit comfortably into every budget.

With CareCredit you can:

  • Start treatment and care immediately and pay over time
  • Pay for other medical expenses for you and your family withouthaving to reapply
  • Pay for deductibles and treatment not covered by insurance
  • Have no annual fees


Call 203.656.9999 to schedule a consultation today!

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722 Post Road, Suite 202 Darien, CT 06820 Directions »
Phone: 203.656.9999
Fax: 203.655.0099