Patient Resources

Payment Options

Salem Plastic Surgery proudly accepts the following forms of payment:
American Express

Patient Forms

As a convenience for our patients, and to save you time on your first visit, you can print the following forms, fill them in, and bring them with you. If you have any questions when filling out these forms, please do the best you can, our staff will assist you with your questions on the day of your visit.

Salem Plastic Surgery | Patient Resources | Winston Salem NC | Greensboro NCNote: These files are in PDF format. If you do not have Adobe® Reader® on your computer, you can download it for free by clicking here or on the Get Adobe Reader icon.


Provided to all patients as a part of comprehensive patient care package.




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