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Patient Paperwork

Prior to any Plastic Surgery or Skin Care Services our office needs completed patient forms. 

 

Click on the PDF next to the paperwork you've been asked to complete by our staff.  Please print, fill out completely and bring it with you to your next appointment. If you need assistance, please contact our office. 970-242-9127

If you are a patient seeing Dr. Merkel or one of our aestheticians, please complete forms 1, 2 and 3.

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1) Patient Confidential Information

2. Confidential Medical History

3.  Medication Record

Request an appointment at the clinic for breast augmentation, skin care, stem cell injections, laser hair removal, or any other plastic surgery needs.

Plastic Surgery in Grand Junction, Cosmetic Surgery, Doctor Merkel

Serving Montrose & Grand Junction for over 40 years

2525 N 8th St, #203,
Grand Junction, CO 81501

2798 Woodgate Rd, Unit C, Montrose, CO 81401

info@wdmerkel.com

Tel: 970-242-9127

Toll Free: 800-341-7668

Fax: 970-242-8304

 

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Hours

Mon: 8:00am - 5:00pm

Tue: 8:00am - 5:00pm

Wed: 8:00am - 5:00pm

Thurs: 8:00am - 5:00pm

Fri: Closed

 

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