Plastic and Oral Surgery | Patient Resources

When you arrive to the office in the Hunnewell Building, 1st floor, check in at the front desk. There, one of our staff will verify your personal information and collect the copayment for your visit. You will then be asked to complete a few forms, including a history and physical form answering questions about your health history. To save time at check-in, print and fill out these forms ahead of time and bring them with you.

Below we have provided useful checklists and forms to help you prepare for your appointment

A checklist for your child's Plastic and Oral Surgery appointment

Name, address, and telephone number of your referring physician

Name, address, and telephone number of your primary care physician (family doctor)

Completed history and physical form

List of medications and dosages your child is taking

Any medical records, X-rays, ultrasounds, MRIs, or lab results from other facilities

Social Security number of the patient and the subscriber on the insurance

Insurance card(s) and insurance information

Insurance referral

Co-payment (payable at time of service)

For worker's compensation or accident/injury-related visits

Claim number

Name of adjuster

Contact telephone number

Address of worker's compensation company

Other helpful items to make your visit more enjoyable

Books to read while waiting

Snacks

Formula, diapers, or a change of baby clothes

Favorite toys

Important forms

You may find it helpful to fill out the following forms before your office visit:

• Patient registration form
• Medication history (PDF)
• Medical record release form
• Medical history form (English)
• Medical history form (Spanish)

In the Boston Children's Department of Plastic and Oral Surgery, your comfort and satisfaction with your experience is of the utmost importance to us. Please download the following form and bring it with you to your appointment, or feel free to complete and fax the survey back to us following your visit. Your responses help to set the standard for the quality of care we provide:

• Post-visit satisfaction survey

After the doctor has seen your child, you may need to stop at the front desk to make a follow-up appointment. At any time, please do not hesitate to ask one of our staff for assistance or information.