Patient Forms

 

Welcome to our Forms Download Center, where we make it easy for you to access essential documents tailored to your needs. Depending on your location, you can download three key forms: the Patient Intake Form for sharing your personal and medical information, the HIPAA Agreement ensuring the protection of your health information, and the Arbitration Agreement Form, which outlines our conflict resolution process. Each form is clearly labeled and formatted for quick and secure completion, streamlining your visit with us.

Simply select your location from the options provided to ensure you receive the correct forms for your area. Our goal is to simplify the process so you can focus on what truly matters – your health and peace of mind. For assistance, feel free to contact our support team.

Santa Rosa, California

 

Intake Forms

pdf

HIPAA

pdf

Arbitration

pdf

Napa, California

 

Intake Forms

pdf

HIPAA

pdf

Arbitration

pdf

Maui, Hawaii

 

Intake Forms

pdf

HIPAA

pdf

Arbitration

pdf

Dr. Walter Tom

Transforming Beauty, Enhancing Confidence

 

Dr. Walter Tom, a highly respected cosmetic surgeon, established the Aesthetic Laser & Vein Centers in 1999 with a mission to boost patients' self-confidence by enhancing their self-image through cutting-edge technology and education, all delivered in a warm, safe, and welcoming environment.

Dr. Tom’s personal philosophy centers on holistic patient care, emphasizing natural-looking results that reflect patients’ best selves. His approach has earned him the Press Democrat’s “Best Cosmetic Surgeon in Sonoma County” award for four consecutive years, along with a “Best Aesthetician” award for his office in 2019.

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