Patient Forms

South Bend, IN Plastic Surgery Patient Forms - Stephen Zucker, MD

If you are a new patient to our office, the attached file contains our new patient packet with forms that will need to be filled out when you arrive at our office.  Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them upon your arrival.  Thank you and please call our office if you have any questions.


New Patient Information Packet

HIPAA Privacy Practices Packet

Financial Policy Packet

New Patient Massage Packet

New Patient Aesthetics Packet

List of Medications to Avoid

Map To Our Office

Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.