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Patient Forms

To save time on your first visit, Complete the following forms and bring them with you.

Please click on a form below to view and print.

Cancellation & Return Policy

Patient Demographic & Medical Sheet

Skin Type Score Sheet

Wrinkle Scale Sheet

Authorization to Release Photographs

 

Financial Agreement

Third Party Insurance Companies and Medicare

The majority of rejuvenating aesthetic procedures and anti-aging skin care treatments fall under the category of cosmetic procedure, and as such, will not be covered by the third party insurance providers or Medicare. However, on specific instances, the insurance companies may consider the above-mentioned procedures and treatments as “Medically Necessary” and be willing to compensate you for your treatment fees. Any or all of the following criteria may be utilized by these companies to reach to this decision: Lifestyle Disruption, Pain, Failure of Conservative Measures Complications.

You will be responsible for contacting your insurance company and/or to complete and file all the necessary forms to arrange for the possible reimbursement of your treatment fees. Artisan Aesthetics will provide you all the applicable CPT codes and other required data.

Payment

Artisan Aesthetics’ charges for the purchased treatment(s), package(s) and/or skin care product(s) are to be paid in full prior to the initiation of the treatment. Treatment(s), package(s) and/or skin care products can be purchased via telephone order. We gratefully accept cash, personal checks, MasterCard, Visa, and Discover credit cards payments. Arrangements for mail delivery of gift certificate(s) and/or skin care products to your desired address can be made.

In an attempt to assist you with obtaining private financing for your treatment fees, Artisan Aesthetics has agreed to accept payments from Care Credit® Patient Payment Plans (dba GE Credit).  Additional information and application form can be obtained through CareCredit.com, or from the Artisan Aesthetics’ staff.  On your first appointment, Artisan Aesthetics staff will also provide you with our Center’s required “Practice Code.”

Quick Enquiry

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Specials

Artisan Med Spa is please to offer you great specials to help you save money on the treatments you love!

Check back each month
for our new offerings!
TOLL FREE! 817-423-5400

Contact Address

5500 Overton Ridge Blvd, Suite250
Fort Worth, Texas 76132

817-423-5400