Town Center Surgery - Medical History Questionnaire

We encourage you to download and print our Patient Information Form & Medical History Questionnaire prior to your appointment. You can fill them out at home to save time and have your personal records available. The forms have been designed so that you can open and print them from your web browser using the Adobe Acrobat Reader®.

Phone: 661-260-3021
Fax: 661-260-3394

If you do not have the free Acrobat Reader® utility for viewing PDF forms, you can download it by clicking on the link below:

Download Adobe Acrobat Reader

 

 

661-260-3021

Valencia Plastic Surgeon Dr. Lussier with a patient
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