Patient Forms

Lutherville, MD

Bel Air, MD

410.828.9570

Contact

New Patient Forms

If you have already scheduled your appointment you will need to fill out the New Patient Forms. You can print and fill out the forms below and bring them with you to your first appointment.

Lutherville, MD

1300 York Road Building A, Suite #100
Lutherville, MD 21093

Bel Air, MD

602 S. Atwood Road Suite 101A, Bel Air, MD 21014

Ellicott City, MD

8450 Baltimore National Pike #165 Suite #116 within MySalon Suites
Ellicott City, MD 21043

410.828.9570

Dr. Brent Birely is a board-certified plastic surgeon with offices in Lutherville and Bel Air, serving patients from Baltimore, Towson, Columbia, Westminster, and other Maryland cities. He is a very well regarded leader in cosmetic surgery and patient safety, and specializes in procedures including breast augmentation, tummy tuck, mommy makeover, facelift, and body lifting procedures after weight loss.

*The content/images on this website are not a guarantee of individual results. Individual results may vary. The information provided on this site is for general informational purposes only and does not replace the need for a formal consultation with a plastic and reconstructive surgeon before undergoing a surgical procedure or skin care treatment.

New Patient Forms

New Patient Form – Surgery

New Patient Form – MedSpa

Lutherville, MD

Bel Air, MD

Ellicott City, MD