Clinic

Scheduling

To schedule an appointment, please call us at 651.632.9700.

Please arrive to your appointment prepared with a list of medications you are taking, if any. You will also be asked to provide a medical history so we can best accommodate your needs. Any patient arriving under 18 years of age must be accompanied by a parent or legal guardian.

We accept most insurance carriers and our services are available to all who seek them. You may become our patient either by making the appointment yourself or through a physician referral. If your insurance plan requires a referral to see a specialist, please contact your primary care physician to verify that a referral has been issued to us for your visit.

We strive to keep waiting times to a minimum, but please realize that delays can occur due to emergencies and unforeseen patient needs.

Cosmetic Consultation Policy:

If you are calling to schedule a self-pay consultation for a cosmetic procedure, please note that a $75 consult fee will be assessed. During your consultation, the physician will meet with you to discuss your concerns, assess your medical history, and make recommendations that will meet your individual needs. The $75 consultation fee can be applied to ANY cosmetic treatment performed by our physicians within 6 months of your consultation – including treatment done at the time of the initial visit.

We ask that you call 24 hours in advance to cancel or reschedule your appointment to avoid any charges. If you have any other questions regarding this policy, please be sure to ask our scheduling department when making the appointment at 651.632.9700.

No Show & Cancellation Policy:

We understand that emergencies and special circumstances happen; we will do our very best to accommodate your specific needs. Should you need to cancel an appointment, please provide as much notice as possible in order for us to allow another patient to fill the appointment slot. In the case that you are unable to make your scheduled appointments, please provide a 24-hour advance notice by calling 651.632.9700. In the event a 24-hour notice is not given, a fee of $50.00 may be assessed for clinic appointments.

Forms/HIPAA

Midwest Facial Plastic Surgery is dedicated to providing you the highest quality of health care at the best value. We are also dedicated to protecting you and your family’s medical records. If you have any questions regarding the completion of the below forms, please reach out to our medical records at (651) 702-0750.

• Authorization for Release of Information
• Authorization for Share Protected Health Information
• Consent to Provide Treatment for a Minor Child
• HIPAA Request for Amendment to Records

FMLA, Insurance, Disability and Other Patient Requested Forms

We are happy to assist you in the completion of your required forms. Insurance forms, disability forms, Family Medical Leave Act forms, Return to Work forms, etc. are completed and processed by our clinical staff and not our surgical staff. Midwest Facial Plastic Surgery has a standardized form for FMLA and Disability Paperwork. If your employer accepts this standard fee these Midwest Facial Plastic Surgery forms are completed at no cost to the patient. If your employer will not accept our forms, a $10.00 administrative fee will be charged for each non-Midwest Facial Plastic Surgery form completed.

Please be aware, on the day of your surgery, your physician will not accept any of these forms. For your physician to better assist you in the completion of your forms in a more timely manner you should mail them to our clinic in Woodbury. Please do not hand deliver them to the clinic where you were last seen.

Please mail your forms to:

Midwest ENT Specialists
ATTN: Medical Records
217 Radio Drive
Woodbury, MN 55125.