Plastic Surgery Procedure

Patient Information – Plastic Surgery Procedure

Welcome to Dr. Beam’s Office…………………………………………………………………FOR
COSMETIC PATIENTS Thank you for selecting us for your plastic surgery
needs. We will strive to provide you with the best possible care. Please fill out
this form completely. If you have any questions, please ask us–we will be happy
to help.
PATIENT’S PERSONAL INFORMATIONToday’s Date:3/11/2013
Patient’s Name:Date Of Birth:
Harold E. Beam, M.D.

Come Visit Us

COSMETIC AND PLASTIC SURGERY IN GLASTONBURY, CT Location Map

ADDRESS:

300 Hebron Avenue, Suite 101
Glastonbury, CT 06033

CALL TODAY to schedule a consultation

860-266-6502
SCHEDULE YOUR CONSULTATION
860-266-6502
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