Consultation / Patient Forms

All patients are required to meet with Dr. Puri prior to undergoing any cosmetic or reconstructive surgery. At that time, different options will be discussed. Then, you.and Dr. Puri can decide on the most appropriate procedure. All of your questions will be answered. The normal postoperative course and possible complications will be explained. Our staff will then discuss the surgical fees and insurance issues. As initial consultations with Dr. Puri are quite extensive, please allow at least one hour for the initial visit.

To set up a consultation with Dr. Puri, please call the office at (248) 362-2300. Our office hours are Monday to Friday (8am-4pm). If you would like more information regarding any of the procedures, a brochure can be sent to you. Please send an e-mail with your name, address and procedure you are interested in to ppuri@eplasticsurgeon.net.

New Patient Forms

Below are the forms that are needed for new patient appointments. To save time on the day of your appointment, please fill them out completely and bring them with you at the time of your appointment. If you have any questions, please fill out as much as you can and our staff will be happy to assist you when you come to the office. Please do not mail them to the office.

If you have Blue Care Network Insurance, we will need your referral form before you can be seen. If you are being referred by your dermatologist and there is a pathology report that would be helpful, please be sure that you bring that also.



Established Patient Forms

For established patients, please print and fill out the following set of forms. We are required to do yearly updates on existing patients. If your insurance has changed, please bring the new insurance cards