800.683.5476 (LIPO)
35A East 84th Street, Suite A, New York, NY 10028

Patient Forms

NYC Lipo requires the below patient forms to be completed before your liposuction consultation. For your convenience, we allow you to print all of the necessary forms online to save you time during your consultation. Patients can fill out the necessary paperwork beforehand in preparation for their liposuction appointment. You can view and print each form by clicking on the corresponding links below.

*Disclaimer: The information contained on this website is intended to be purely educational in nature and does not create a physician-patient relationship with NYC Lipo LLC or any agent, servant or employee thereof. By no means should the information contained in this website be considered as a substitute for consultation with a qualified physician and it does not constitute a second opinion. This website and its contents do not represent or claim to provide the information needed for a patient to give his or her informed consent to any surgical procedure or are a reflection of individual patient results, as they may vary patient to patient. Individual results will vary and no guaranteed result is stated or implied by any photo use or any statement, testimonial, or video on this website. The results depicted in “before” and “after” pictures and stated by any “patient testimonial” illustrate results you may or may not achieve if you choose to have a cosmetic surgery or dermatology procedure. Individual results may vary by patient. Please see our Notice of Privacy Practices.