Please fill out the form below to receive more information on the services the North Carolina Plastic Surgery Center has to offer, or call Angie Collins at the number above to schedule an appointment for a consultation.

We at the North Carolina Plastic Surgery Center, P.A. follow the HIPAA (Health Insurance Portability and Accountability Act of 1996) standard. The HIPAA Privacy Rule establishes standards to protect the confidentiality of individually identifiable health information maintained or transmitted electronically in connection with certain administrative & financial transactions. The rule provides new rights for individuals with respect to protected health information about them & mandates the obligations of health care providers, health plans, & health care clearinghouses. Training of every staff member on the new rights & new policies & procedures as they apply to the healthcare operation is also required. The compliance date for privacy is April 14, 2003.

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Name * Email * Address City State Zip Phone * Fax What type(s) of aesthetic surgery are you interested in? Breast Enlargement Breast Reduction Tummy Tuck – Abdominoplasty Ultrasonic Assisted Liposuction Facelift Eyelid Lift Cleft Lip & Palate Surgery Scar Revision Male Breast Reduction Botox® Tattoo Removal Breast Lift Breast Reconstruction Liposuction Rhinoplasty Forehead Lift Ear Pinning General Reconstructive Surgery Hand Surgery Hair Replacement Surgery Obagi Products Would you like to receive more information? Yes    No How would you like to be contacted? Phone    Email    Fax    Mail    Please enter any additional question or comments below. Please do not send confidential information via this form, especially credit card numbers! When we place an order form on our site (soon), it will use S.S.L. (Secure Socket Layers), which is necessary for secure credit card processing.

 



Complete Privacy Rule Text (Adobe reader download)