Important Forms

The following forms are for your convenience. You may download them, print them, fill them out and bring them to your next appointment.

Medical Spa Forms

Cosmetic Clinic Intake Forms

Please fill out the form below to contact us. If this is an urgent medical issue, do not use this form, please call 360-823-0860.

Name*
First Last
How would you like to be contacted?*
- Phone
- Email
Email*
Phone*
When is the best time to call?
- Morning (9 a.m. - Noon)
- Afternoon (Noon - 5 p.m.)
- Anytime
May we leave a message?
- Yes, please leave a message.
- No, do not leave a message.
Call-Back Instructions
Please let us know if you have any special call-back instructions. Please DO NOT send any personal or medical information in this form.
Specials
- Yes
Do you want to receive monthly spa specials, including discounts on laser treatments, BOTOX, cosmetics, and much more?
Consent*
I authorize Salmon Creek Plastic Surgery to contact me**
** By submitting this form, I agree to be contacted by Salmon Creek Plastic Surgery at the phone number and/or email provided. If indicated, I authorize Salmon Creek Plastic Surgery to leave messages for me including Salmon Creek Plastic Surgery's name, the return caller’s name, and contact information. I understand that in so doing, Salmon Creek Plastic Surgery cannot protect this information and that others with access to my electronic equipment (e.g., mobile phone, voicemail, email, or computer) could have access to this message. We do not share this information with any outside organizations.
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.