• Bonita Springs 239-947-FACE
  • Marco Island 239-394-6637
  • Fort Myers 239-947-3223

New Patient Form and HIPPA Privacy Form

Please assist us by bringing in your New Patient form to us to or by faxing it prior to your appointment to CaseyOMFS@hotmail.com 239-947-6631

HIPAA Privacy Form for your Review

    Upload Patient Form

    Request your Complimentary Consult.

      What is your main interest?

      Facial Cosmetic Evaluation (Botox, Juviderm, fillers)Rejuv Facial Spa Services (Facials, Microderms, Peels)Facial Surgical Evaluation (Facelift, Eyelid surgery, Laser resurfacing)Body Surgical Evaluation (Tummy Tuck, Breasts, Lipo Suction)