Mansfield*Cosmetic*Surgery*Center* *New*Patient*Welcome*Packet* 817>477>9000* *
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- Jean Fletcher
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1 DearPatient, WelcometoMansfieldCosmeticSurgeryCenter,thecosmeticsurgerypracticeofDr. MichaelL.Thornton,afellowship>trainedcosmeticsurgeonandDiplomateoftheAmerican BoardofCosmeticSurgery. ThisNew$Patient$Welcome$Packetwillspecificallyprovidevaluableinformationaboutthe variouscosmeticsurgeryservicesofferedatmansfieldcosmeticsurgerycenter.itwillalso containinformationaboutourcosmeticsurgicalpractice,profileofdr.michaelthornton, ourofficehoursandlocation,theappointmentandconsultationprocess,aswellasprovide informationaboutyourfinancialoptionstoobtainaffordablecosmeticsurgery. Toexpediteyouroverallconsultationprocess,pleasetaketimetocompletetheattached Medical$HistoryformbeforeyourvisitwithDr.MichaelThorntonandbringtoyour consultation.ifyoudesire,youmayeither orfaxthecompletedformpriortoyour officevisit.asitwillexpediteyouroverallconsultationprocess Feelfreetocontactourofficetodiscussanyconcernsyoumayhaveaboutyourcosmetic surgeryconsultation.itisveryimportantthatyourquestionsareansweredbeforeyou undergoanysurgicalornon>surgicalprocedure. Sincerely, Dr.MichaelL.Thornton&Staff MansfieldCosmeticSurgeryCenter Office Fax3 MansfieldCosmeticSurgeryCenter NewPatientWelcomePacket 817>477>9000
2 About Us MansfieldCosmeticSurgeryCenterwasestablishedin2008underthesurgicaldirectorship ofdr.michaell.thornton,afellowship>trainedcosmeticsurgeonanddiplomateofthe AmericanBoardofCosmeticSurgery.OurofficeislocatedinMansfield,Texas,andweserve clientsfrommansfield,arlington,fortworth,dallas,andthesurroundingcitiesofnorth CentralTexas. Our3500sq.ft.cosmeticsurgerycenterandmedicalspaisconstructedonthegorgeous Mediterranean>styleexecutiveofficepropertyoftheTuscanonWalnutCreek,locatedin Mansfield.OursurgicalofficefeaturesalargeandspaciousfoyeraccentedinTuscan grandeur,threeprivateexaminationrooms,ourmedicalspafacility,andourprivate operatingroom. Duringyourcomplimentaryconsultation,Dr.Thorntonwillpersonallyevaluateyour health,conductaprivatephysicalexamandexplainwhichcosmeticsurgicalprocedures aremostappropriateforyouasitrelatestoyouruniqueandpersonalcircumstance.your privatecosmeticsurgeryconsultationisbookedforapproximatelyonehouranddr. Thorntonwillspendasmuchtimenecessarytoestablishacomprehensiveandthorough physician>patientrelationshipwithyou.thislevelofpersonalattentionfromdr.thornton iswhatdefinesoursurgicalpractice.althoughwellqualified,wechoosenottousea patientcoordinator,nursepractitioner,orphysicianassistant(pa)toperformyour consultation.inaddition,dr.thorntonwillpersonallyseeyouduringeverypost>operative visitfollowingyoursurgerytopersonallyaidinyourhealingprocessandprovide physician>levelcare. CosmeticsurgeryproceduresrequiringgeneralanesthesiaareperformedatBaylor$ Surgicare$at$Mansfield,anout>patientAAAHCcertifiedsurgicalfacility,locatedjustafew milesfromouroffice.however,cosmeticsurgeryproceduresrequiringminimalsedation, maybeperformedinourownprivateoperatingroom.furthermore,dr.thorntonhasfull cosmeticsurgeryandgeneralsurgeryprivilegesatthemedicalcenterofarlingtonto manageanypostsurgicaldifficulties. MansfieldCosmeticSurgeryCenter NewPatientWelcomePacket 817>477>9000
3 About Dr. Michael L. Thornton GrowingupinTexas,Dr.Thorntonreceivedhispremedical Bachelor sdegreefrombayloruniversityandreceivedhis MedicaldegreefromtheUNTHealthScienceCenterinFort Worth.Hecompletedacomprehensivefive>yeargeneral surgeryresidencythroughmichiganstateuniversity affiliatedhospitalsatmountclemensregionalmedical CenterinMountClemens,Michiganandcompletedan additionalone>yearfellowshipinsurgicalcriticalcareand TraumaSurgeryattheinternationallyrecognizedRAdams CowleyShockTraumaCenterattheUniversityofMaryland MedicalCenterinBaltimore,whereheacquiredextensive knowledgeinthemanagementandreconstructionof complextraumaticinjuries. Followingacreativepassion,Dr.Thorntonfurtheredhis surgicalexpertisebycompletinganadditional,12>monthadvancedfellowshipincosmetic Surgery,accreditedandrecognizedbythe3AmericanAcademyofCosmeticSurgery,where hegainedconcentratedknowledgeinallmajorareasofcosmeticsurgeryincludingfacial plasticsurgery,rhinoplasty,cosmeticbreastsurgery,liposuction,bodycontouringsurgery, non>surgicalaesthetics,skincarerejuvenation,andlasermedicine. Dr.ThorntonisaDiplomateofthe3AmericanBoardofCosmeticSurgery(ABCS),whichis theonlywrittenandoralcertifyingboardthatexclusivelytestsknowledgeandexperience inartofcosmeticsurgery,andheiscurrentlyservinga3>yeartermasanoralboard examinerfortheabcs.inaddition,heisdual>boardcertifiedbytheamericanosteopathic BoardofSurgeryinbothGeneralSurgeryandSurgicalCriticalCare/TraumaSurgery. BecauseofDr.Thornton sthreeboard>certificationsandsurgicaldedication,hehasbeen bestowedtwoesteemedhonorsasfellow$in$the$american$college$of$osteopathic$surgeons$ (FACOS)andasFellow$in$the$American$Academy$of$Cosmetic$Surgery$(FAACS).Inaddition,he hasover14>yearsofcombinedsurgicaltrainingandoperativeexperienceandhasbeen named TopDoc infortworth,texasmagazine,inthespecialtyofcosmeticsurgery. Dr.Thorntonisatalentedandcompassionatecosmeticsurgeonandhisphilosophyisfor youtoachieveanaturalandimperceptibleresultthatfocusesonyourspecificgoals,while carefullyattemptingtominimizeanyscars.hebelievesyourcosmeticsurgeryisonly successfulwhenyouarehappyandpleased! MansfieldCosmeticSurgeryCenter NewPatientWelcomePacket 817>477>9000
4 Affordable Cosmetic Surgery MansfieldCosmeticSurgeryCenteroffersoptionsforaffordablecosmeticsurgeryby acceptingmajorcardcardsincluding,mastercard,visa,andamericanexpress. Inaddition,wearepleasedtoofferCare$Credit,oneofthenation sleadingcosmeticsurgery paymentprogramsmakingiteasytoaffordcosmeticsurgeryproceduresyoudesire.with Care$Credityoumayfinanceyourcosmeticsurgeryprocedureswithoutupfrontcosts,no annualfees,andnopre>paymentpenalties.so,youcanscheduleyourproceduretodayand convenientlypayovertimewithlow,monthlypayments.seebelowformoredetailsorto applyforanon>lineapplicationofyourchoosing. Contact Us / Office Location MansfieldCosmeticSurgeryCenterislocatedintheheartoffMansfield,TexasonNorth WalnutCreekDrive,justwestofHwy287pasttheWalmartandUnitedMethodistChurch. Tobetterassist,youmayclickthe ContactUs tabonourwebsiteandfollowdirections usinggooglemaps.pleasecontactourofficeifyouhaveanyquestionslocatingouroffice. MansfieldCosmeticSurgeryCenter 550N.WalnutCreekDrive,Ste120 Mansfield,TX76063 OfficeHours: MondaythruFriday 9am 5pm ConsultationswithDr.Thorntononly Monday,Wednesday,andFriday MansfieldCosmeticSurgeryCenter NewPatientWelcomePacket 817>477>9000
5 Cosmetic Surgery Procedures FACIAL3COSMETIC3SURGERY3 EyelidLiftSurgery Blepharoplasty FaceLift NeckLift MiniFaceLift BrowLift FacialFatTransfer&Grafting TornEarlobeRepair Keloids SurgisilPermalipImplant Chinimplant BODY3CONTOURING3SURGERY3 Abdominoplasty MiniTummyTuck MommyMakeOver Liposuction LaserLiposuction Brachioplasty ArmLift BrazilianButtLift HandRejuvenation AfterWeightLoss PostBariatricSurgery AbdominalHerniaRepair Sclerotherapy SpiderVeinInjection BREAST3COSMETIC3SURGERY3 BreastAugmentation BreastLift BreastReduction BreastRevisionSurgery Gynecomastia MaleBreastSurgery MEDICAL3SPA3 3AESTHETIC3PROCEDURES3 CO2LaserSkinResurfacing Botox Juvederm Radiesse Latisse IPL Photofacial Microdermabrasion ChemicalPeels Facials Waxing PermanentMakeup Obagi SkinCeuticals MansfieldCosmeticSurgeryCenter NewPatientWelcomePacket 817>477>9000
6 Mansfield Cosmetic Surgery Center 550 N. Walnut Creek Drive, Ste 120 Mansfield, TX New Patient Medical History - Cosmetic Surgery Full Name Date Address City State Zip address SSN# Home phone Business phone/cell Emergency Contact: Name Phone Date of Birth Age Male Female Marital Status Occupation/Employer Ht Wt (lbs) Race: Caucasian African American Hispanic Asian Other How did you hear about us? Friend Internet Magazine Other Reason for visit why are you here today? Who is your primary care physician? Is a physician currently treating you? List medication(s) you are presently taking: Are you taking any of these specific medications? Birth Control NSAIDS / Aspirin Blood Thinners Vitamin E / Herbals Testosterone Steroids Accutane Thyroid List allergies to medication(s):
7 Mansfield Cosmetic Surgery Center 550 N. Walnut Creek Drive, Ste 120 Mansfield, TX New Patient Medical History - Cosmetic Surgery Do you have any of the following conditions? AIDS High blood pressure Stroke Anemia Infection (active) Thyroid problems Arthritis Keloid scars Tuberculosis (TB) Asthma / COPD Kidney disease Ulcers Breast lumps Liver disease Venereal disease Breast cancer Chemotherapy Lupus Melanoma Diabetes Mental disorder Weight loss: How much? Dizziness Nervous disorder Weight gain: How much? Epilepsy Fainting Hay Fever Heart disease Hepatitis Radiation treatment Respiratory disorder Skin conditions Sinus problems Stomach problems Please list any other medical conditions? List all previous surgeries: Smoking History: Non-Smoker Smoker packs per day for years. Quit years ago. Do you drink alcohol? List all family history (cancer, deaths, etc) Females Only: Number of children Are you pregnant? YES NO Are you breast feeding? YES NO Any other concerns or information we should know about you? I have answered the above questions truthfully and will notify you of any changes in medications and physical conditions. Patient Signature: Date:
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