Here at the office of Dr. Beverly Friedlander, we are dedicated to excellent patient care. You can find all of our forms in one convenient location which allows you to download and complete them prior to your visit as well as other information to help make your check in process even easier.Need Help?
Plastic Surgery Patient Forms
For your convenience, we have provided all of our forms online. Please bring a completed copy of all forms to your first consultation. Click to view, print or download. If you have any questions when filling out these forms, feel free to call us at 973-524-7124. Please bring your completed forms with you on the date of your consultation.
Payment can be made in the form of cash, check or credit card at the time office services are rendered. We accept AMEX, Visa, MC and Discover.
We do charge for consultations. There is a fee of $100 for cosmetic consultations, payable at the time of service. This fee is applied to the cost of you surgery. In office services are not included.
If you are unable to keep an appointment, we ask that you kindly provide us with at least 24 hours’ notice. This courtesy, on your part, will make it possible to provide our wait listed clientele with services. We hold your credit card but do not charge it unless you forget to cancel or don’t arrive for your appointment. The charge for a “no show” is $100.
We ask that you contact us if road conditions are unfavorable and you anticipate being more than 15 minutes late for your appointment. We will do our very best to accommodate you under all circumstances.
We will review all costs with you at the end of your consultation. Once you have decided to have surgery, a deposit will be collected to secure a surgery date, and the balance will be collected at your pre-op visit 2-3 weeks prior to surgery. Payment can be made by cash check or credit card.
We are pleased to offer cosmetic surgery financing. This allows you to pay for your treatment over time with convenient monthly payments. Applying is fast and easy and often approval is obtained within minutes. We are affiliated with Alpheon credit and CareCredit.
By electing to finance your procedures you can decide to have surgery and look and feel your best at a time that is right for you. Both companies offer convenient financing options to fit your lifestyle and budget.
Beverly Friedlander, MD does not participate with any health insurance plans. Cosmetic procedures are those procedures intended to improve your appearance and self esteem. Cosmetic procedures are not covered by any insurance policy. The provisions of health insurance plans are highly variable, so when indicated we will submit preauthorization and pre-certification requests. We will also file insurance claims on your behalf. Payments are made in advance of surgery unless other arrangements have been made. We also provide services involving Motor Vehicle (No-Fault) Claims and Worker Compensation Claims.