New Patient Forms
Forms
The team at Lou Plastic Surgery looks forward to meeting you and discussing your goals. We strive to keep our appointments on time as scheduled. Prior to your appointment, we encourage you to fill out the patient forms that are located on this website so you can accelerate your check-in process. Please click the pdf below and complete the forms prior to your appointment. If you are unable to fill out our patient forms, then it is recommended that you arrive at your appointment 15 – 30 minutes early so you can have ample time to fill out the appropriate forms.
TouchMD
Stay Up-to-Date with the Latest Technology at Lou Plastic Surgery!
At Lou Plastic Surgery in Houston, Texas, we are committed to providing the best possible experience for our patients. That's why we are excited to announce that we have added the TouchMD app to our practice.
The TouchMD app is an innovative tool that allows you to stay up-to-date with the latest technology and to easily manage your appointments, treatments, and more. With the app, you can take a closer look at customized treatment plans, read reviews from other patients, view before and after photos, and stay informed about the services and promotions offered by our practice.
We believe that this new tool will help to enhance your experience with Lou Plastic Surgery, and we encourage you to download the app today. The TouchMD app is available for both iOS and Android devices and can be downloaded for free from the App Store or Google Play.
Don't miss out on this exciting opportunity to stay connected with Lou Plastic Surgery and take advantage of all the great features that the TouchMD app has to offer. Download the app today and start exploring!
Policies
We require all insurance patients to provide valid credit card information at the time of booking their appointment. If the patient needs to reschedule or chooses to cancel the appointment a 48-hour notice must be given. If the patient does not give 48-hour notice and does not come in for the scheduled appointment a $100.00 no show fee will be charged for the missed appointment. This will be charged directly to the patient, not the insurance carrier.
Cosmetic Consultations: All patients scheduling for a Cosmetic Consultation must provide valid credit card information at the time of booking the appointment. A nonrefundable $100.00 consultation fee will be charged to the credit card provided at the time of scheduling the appointment. If the patient chooses to schedule surgery, the $100.00 will be applied to the total cost of surgery otherwise the $100.00 is forfeited. If the patient needs to reschedule or chooses to cancel the appointment a 48-hour notice must be given. If the patient does not give 48-hour notice and does not come in for the scheduled appointment, an additional $100.00 no show fee will be charged to the authorized card on file for the missed appointment.
Injectables: All patients scheduling for any Injectables appointment will be subject to a nonrefundable deposit of $150 for Botox/Dysport/Fillers at the time of booking the appointment. This fee will be applied to the total amount of injectable services rendered at the appointment. Injectable deposits are subject to the missed, canceled, and rescheduled appointments policy.
Med Spa Refund Policy: LouMD Medspa does not issue refunds for any service that was purchased, including pre-paid services/packages. However, to ensure our patients always have a pleasant experience at LouMD Medspa, unused or remaining treatments may be transferred to another service or applied as a medspa credit to your account.
During your consultation, we will discuss treatment options, benefits, and risks associated with each treatment so that each patient can choose the approach that is best suited for their needs and budget. It is virtually impossible to predict results and therefore payments made for services are for treatments to be performed -- not for a specific result. However, we always strive to achieve the absolute best result that we can for you.
Cancellations: We require a notice of cancellations and/or rescheduling 48 hours in advance. This is intended to increase physician and staff productivity, to improve timely access to all patients, and to reduce and/or eliminate empty slots in the appointment schedule. If you fail to keep your appointments without notifying us in advance: a missed and/or rescheduling appointment fee will apply. These fees are typical $100.00 but not to exceed 100% of the cost of your scheduled appointment. A new payment is expected to schedule another visit. Repeatedly missed and/or rescheduled appointments without notification may cause you to be discharged from the practice so that we can provide care to other patients. Rescheduling a surgery will be subject to additional fees as stated on the Surgery Proposal provided to the patient and signed by the patient.
Future appointments of ALL types (Follow-up appts, Post-op appts, Post-procedure appts, Med Spa appts, Laser appts, Injectables, ETC.), require a working debit/credit card on file to schedule your time slot. You will incur a $100 charge to your card or $100 deduction from any pre-payment(s) on your account if you are a no show, arrive 15 minutes or later, or if cancellations are made within 48 hours of your booked date.