Online New Patient Packet

Please complete all sections (I, II, and III) of your patient packet PRIOR to your appointment.  We must receive your completed paperwork within 48 hours of your scheduled appointment time.  Upon completion of your packet, the results will be emailed to our confidential nurses email address.  You can also indicate an email address where you will receive a copy as well.  Once you start the packet, you cannot save and come back, so please be prepared to complete all sections at one time.  

Dr. Miklos and Dr. Moore are leading surgeons in their field of expertise and take great pride in providing you quality and confidential care.  Patients are highly valued and provided with extensive consultation time with the physician.  Your appointment time is reserved for you alone and therefore failure to arrive at your scheduled time with your paperwork complete, creates a hardship for the practice and patients scheduled after you. Late arrival or incomplete paperwork may result in the need for our office to reschedule your appointment for another day and time.

Section III is a Labiaplasty Questionnaire, to be completed if you are interested in speaking with the doctor about labiaplasty.  Should you have any questions about this form, please do not hesitate to contact our office prior to completing it. 

We are looking forward to meeting you!!!!!!

John R Miklos, MD
Robert D Moore, DO

Online New Patient Packet Sections

Section I

Section II

Section III (Labiaplasty Questionnaire)


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