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Welcome to Atlantic Center Aesthetic and Reconstructive Surgery.

If you'd like to schedule a telemedicine appointment or are in need of a second opinion, please book that appointment now.

If you'd like to schedule an in-office appointment, use the form below to request an appointment and our appointment scheduler will respond within 48 business hours.

Please do not use this form if you have an urgent medical problem or you need to reschedule an existing appointment.

Patient Registration Forms

The Atlantic Center of Aesthetic & Reconstructive Surgery welcomes you to our practice. Once you have made your initial appointment, you may pre-register by downloading, printing, and completing the forms below. Please be sure to bring them with you to your first visit, along with any diagnostic films or other test results that may have been ordered or performed by another physician. Completing the forms prior to your visit will help speed up the new patient registration process.

Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.

 

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Our Locations

  • 100 SE 15 Avenue
    Fort Lauderdale, FL 33301
    Phone: (954) 983-1899
    Fax: (954) 318-3215
  • 10301 Hagen Ranch Road, Suite D930
    Boynton Beach, FL 33437
    Phone: (954) 983-1899
  • 1951 SW 172nd Ave, Suite 200
    Miramar, FL 33029
    Phone: (954) 983-1899
    Fax: (954) 318-3215
  • 26800 Tamiami Trail, Suite 380
    Bonita Springs, FL 34134
    Phone: (239) 766-7989
    Fax: (844) 276-0481
  • 1803 S. 25th St., Suite 5
    Fort Pierce, FL 34947
    Phone: (954) 983-1899
    Fax: (954) 318-3215
  • 12640 Creekside Lane
    Fort Myers, FL 33919
    Phone: (239) 766-7989
    Fax: (844) 276-0481
  • Paragon Medical Building
    9149 Estate Thomas, Suite 104
    St. Thomas, VI 00802-3132
    Phone: (340) 473-3915
  • 12957 Palms West Drive, Suite 203
    Loxahatchee, FL 33470
    Phone: (954) 983-1899
    Fax: (954) 318-3215
  • 1631 NW St. Lucie West Blvd., Suite 201
    Port St. Lucie, FL 34986

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