Patient Forms

Patient Forms
New patients: Please download and complete the new patient packet before your visit with Dr. Hirsch.

Click to download: New Patient Forms


Your privacy is important to us!  Please review our practice privacy policy, which can be downloaded by clicking on the below link titled "Privacy Policy."

Click to download: 
Privacy Policy

Post Operative Instructions



Click on the following link to download the surgical drain output record:

Drain output record


Click on the links below to download post-operative instructions for your procedure:

Cosmetic Breast Procedures:

Breast Augmentation
Breast Lift
Breast Lift with Implants
Inverted Nipple Repair

Reconstructive Breast Procedures:

Tissue Expander Breast Reconstruction
Direct to Implant Breast Reconstruction
Second Stage Breast Reconstruction
Nipple Reconstruction
Free Flap (DIEP) Breast Reconstruction
Latissimus Flap Breast Reconstruction

Cosmetic Body Procedures:

Tummy Tuck
Liposuction
Arm Lift
Thigh Lift

Cosmetic Face Procedures:

Facelift/Necklift
Blepharoplasty
Rhinoplasty/Septoplasty
Split Earlobe Repair