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Patient Resources

Whether you are new to our Ann Arbor plastic surgery practice or are a long-time patient, you’ll find all the information you need for your visit here. Learn about completing your patient paperwork, financing your procedure, insurance and fees, and more. Plus, watch helpful videos created by our Center for Plastic & Reconstructive Surgery team.

Patient Forms

For your convenience, we text or email you the forms to fill out at the time you schedule your appointment. You can also simply click on the links below to complete your paperwork.

• New Patient Registration Form 
• Combined Consent Form 
• Financial Policy 
• Notice of Privacy Practices 

Alternatively, you may download the registration forms here. Please print and complete the forms and mail or fax them to our office at least 5 business days prior to your appointment so that the doctor and the clinical staff can review your information prior to your visit.

Mailing address:
Center for Plastic & Reconstructive Surgery
5333 McAuley Drive, Suite 5001
Ypsilanti, MI 48197
Phone: (734) 712-2323
Fax: (734) 712-2312

For patients requesting the release of their medical records, please complete this form.

If you need information on emergency or urgent care facilities at St. Joe Hospital, please click the links below:

• Emergency Care
• Urgent Care in Ann Arbor

Your First Visit

Here is what you need to know as you plan your first visit to the Center:

• Please review our patient privacy practices.
• Please bring your insurance information and card(s) with you.
• If you are a new aesthetic or nonsurgical patient, you will have additional treatment-specific forms to complete.
• Bring any test results or radiology films that relate to your visit.
• If your HMO, Medicaid, or Workers’ Compensation carrier requires authorization from your primary care physician, be sure you have a referral authorization at the time of your appointment.
• Plan to arrive at least 15 minutes early to check-in so we can process your information. Please allow ample time to park and make your way to our offices on the 5th floor.
• If you cannot keep an appointment, please contact us at least 24 hours in advance by calling (734) 210-0356. A fee will be assessed for late cancellations or no shows.

Insurance and Fees

We work with the following insurance carriers:

This list is not all-inclusive. Please call our office at (734) 712-2323 for a complete list of insurance providers that we participate with.

Please bring all of your insurance information and card(s) with you to your appointment.

Most HMO, Medicaid, and Workers’ Compensation carriers require a referral authorization from a primary care physician or employer before service is rendered. If we do not receive this authorization, you are responsible for payment at the time of service.

Office visit fees and co-pays are due at the time of service. We do accept assignment (the insurance carrier’s payment) for many medically necessary procedures. Medical necessity is determined by your surgeon, and you will be able to discuss your financial responsibilities with your patient representative at our office.

Before your visit, contact your insurance carrier about:

• Your coverage, co-pays, and deductibles
• Any required authorizations
• Any out-of-network restrictions and/or costs

This will help you to avoid any unexpected out-of-pocket expenses.

We file claims for medically necessary procedures only. Referral authorizations received after services are rendered will not be processed. We accept cash, personal checks, VISA, MasterCard, and American Express. We also offer several different affordable payment options, including ZERO percent financing. CPRS does not charge you to use or apply for financing.

Financing With CareCredit®

It’s something you’ve always wanted to do, but something else was always there to hold you back. Well, not anymore. We offer CareCredit, a card designed specifically for your health and beauty needs. CareCredit can help you move forward with getting the procedure you’ve always wanted. With convenient monthly payment options, no up-front costs, and no prepayment penalties, you can get your procedure sooner.

CareCredit is the credit card exclusively for healthcare services. With monthly payments every time you use it, you can use your card over and over for follow-up appointments or different procedures. This means you don’t have to put your health and beauty needs on hold until you save up enough money. We give you the power to decide when it’s the right time for you.

With CareCredit, you can:

• Enjoy monthly payment options
• Pay no up-front costs and no pre-payment penalties.

Learn more at CareCredit.com or ask us for details.

Ready to apply? Apply online for your CareCredit card today.

Video Resources

Why Should I Pay for a Plastic Surgery Consultation?

Wondering why some plastic surgery practices charge a fee for a consultation? Learn about why, along with other things to consider, in this video from the Center for Plastic & Reconstructive Surgery in Ann Arbor.

Pre- and Post-Op Instructions for Separation of Parts

Nurse Robin Gaulrapp explains a Separation of Parts procedure (also called a bilateral muscle flap closure).

How to Use a Jackson-Pratt (JP) Drain

A Jackson-Pratt Drain (also called a JP Drain) is a closed-suction medical device that is commonly used as a post-operative drain for collecting bodily fluids from surgical sites. The device consists of an internal drain connected to a grenade-shaped bulb via plastic tubing. In this video, our nurse Cec shows how to empty your drain. You can also download our Drain Log and Instructions.

Plastic Surgery Recovery Time

Every plastic surgery procedure requires some downtime, though the length of recovery depends on the extent of the procedure. It is important to be patient during the healing process. All bodies are unique, and some people heal quicker than others.

The best way to ensure the desired outcomes from your procedure is to be as healthy as possible before surgery. This entails following a healthy lifestyle with diet and exercise, limiting caffeine and alcohol, and not smoking. Following your surgeon’s specific post-op instructions is also vital for an optimal outcome. This may include instructions on pain medication, physical activity, and cleaning incisions.

Recovery Time Considerations:

• No matter the procedure, patients commonly need at least one week of recovery time. Take this into account when planning your surgery.
• When planning on recovery time, schedule more than you think necessary. Since everyone’s body heals differently, this will allow you extra time if needed.
• You will also need to take more recovery time if your job is a physically strenuous one.
• Patients who are having plastic surgery of the face will experience bruising and swelling, which may be a concern when out in public. If so, you may want to plan healing time around specific social events.

Overall, having a realistic expectation for the outcome of your surgery is important. Be prepared to experience bruising and swelling after surgery, and take the required amount of time to heal. Over time, your incisions will heal, bruising and swelling will fade, and you will be left with your beautiful surgical results.

At the Center for Plastic & Reconstructive Surgery in Ann Arbor, we offer pre-and post-operative care options to our patients to ensure the best surgical outcomes. This may include medically formulated skin products or camouflage makeup.

For more information, please request your consultation with our easy-to-use online form or call our office at (734) 712-2323 to schedule your visit.

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