Our office staff is available to answer your calls Monday through Friday from 9 am to 5 pm.
Please print and fill out each of the forms below in preparation for your appointment with Dr. Scheiner.
- Patient Registration for medical visits through your health insurance.
- If you are seeing Dr. Scheiner for the medical weight loss program, please visit www.DelawareMedicalWeightLoss.com to print the correct paperwork.
Health History: Please choose the appropriate form for the reason of your visit. You only have to fill out the "shaded" questions and boxes, the bottom of the form is for the doctor's use.
- Skin Evaluation
- Cosmetic Surgery Consultation
- HIPAA Privacy Practice
- Consent to be Photographed (only necessary for cosmetic surgical procedures)
Med Spa Services:
Please choose one of the forms below based on the services you are scheduled to receive.
Please note: These documents are in Adobe® PDF format. They require Adobe Reader to be viewed. If you do not have Adobe Reader, you can download it for free by clicking here.
CareCredit for Cosmetic Procedures
It’s something you’ve always wanted to do, but something else was always there to hold you back. Well, not anymore. We offer CareCredit®, a card designed specifically for your health and beauty needs. CareCredit can help you move forward with getting the procedure you’ve always wanted. With convenient monthly payment options, no up-front costs, no prepayment penalties and no annual fees, you can get your procedure sooner.
Like a credit card, but better
CareCredit works just like a credit card, but is exclusive for healthcare services. With low monthly payments every time you use it, you can use your card over and over for follow-up appointments or different procedures. This means you don’t have to put your health and beauty needs on hold until you save up enough money. We give you the power to decide when it’s the right time for you.
With CareCredit, you can:
- Enjoy low minimum monthly payments
- Get No Interest financing if paid within 12 months or fixed, low interest financing for up to 60 months (Additional plans may be available)
- Pay no up-front costs, pre-payment penalties or annual fees.
Learn more by visiting CareCredit.com or asking us for details.
Ready to apply? Apply online for your CareCredit card today.