Registration Forms

Click on the below link to fill out the registration form. Once the form has been completed, please print, sign and bring it to the office.

 

Dermatology Registration Form

Vein Registration Form

Aesthetic Spa Services Registration Form (Facials, Peels, & Microdermabrasion)

Laser Hair Removal Registration Form

AUTHORIZATION FORM For Use and Disclosure of Protected Health Information

Vanquish registration Form

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Do you have a question?

You may E-mail your questions to us at: info@AnnapolisCosmeticCenter.com

Schedule an appointment:

You can schedule an appointment for a consultation by calling the office at:
(410) 974-6444

 

 

 

OUR OFFICE IS COMPLIANT WITH THE CURRENT MARYLAND REGULATIONS
10.32.09 Delegation and Assignment of Performance of Cosmetic Medical Procedures and Use of Cosmetic Medical Devices. This is a Maryland safety regulation which governs who can legally perform medical cosmetic procedures. We guarantee that all injectable treatments (including Botox, Juvederm & Sclerotherapy) and laser treatments are performed by Dr. David Green.