Bassin Center For Plastic Surgery
Free Consultation
877.333.3223
Plastic Surgery Tampa FL, Plastic Surgeon Tampa, Cosmetic Surgeon Tampa Florida, Cosmetic Surgery Tampa FL

Patient Forms

At Bassin Center For Plastic Surgery, Dr. Roger Bassin, his doctors, and staff provide the most advanced and innovative techniques for all your cosmetic needs. We're dedicated to helping you look and feel your best while providing the highest level of patient care. In order to expedite the check-in process during your first appointment, we've provided links to our patient forms below. Simply print the forms, complete them at your leisure at home, and then bring them with you the day of your visit. We look forward to seeing you soon!

LazerLift® - Welcome Home Host Barbara Beck
LazerLift® on The Doctors
Aqualipo® and NaturalFill® on the Dr. OZ show
Aqualipo® and NaturalFill® on the Dr. OZ show

BASSIN CENTER FOR PLASTIC SURGERY

ORLANDO PLASTIC SURGERY
BASSIN PLASTIC SURGERY
422 SOUTH ALAFAYA TRAIL
SUITE 32

ORLANDO, FLORIDA 32828
407.851.3888
METRO WEST PLASTIC SURGERY
BASSIN PLASTIC SURGERY
1601 PARK CENTER DRIVE
SUITE 11

ORLANDO, FLORIDA 32835
877.333.3223

MELBOURNE PLASTIC SURGERY
BASSIN PLASTIC SURGERY
1705 BERGLUND LANE
SUITE 103

VIERA, FLORIDA 32940
321.255.0025

THE VILLAGES® PLASTIC SURGERY
BASSIN PLASTIC SURGERY
8575 NE 138TH LANE
SUITE 103

LADY LAKE, FLORIDA 32159
352.350.9006

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*Disclaimer: The information contained on this website is intended to be purely educational in nature and does not create a physician-patient relationship with the Bassin Center for Plastic Surgery, Dr. Roger Bassin, 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 procedure. Individual results may vary by patient. Please see our Notice of Privacy Practices.