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Jeffrey Takahashi and Mary Jean Takahashi

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Forms

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Please download, print, and complete the medical history and cosmetic interest questionnaire forms and bring them with you to your initial appointment.  If you are not able to print these forms or forget to bring them with you to your appointment, don’t worry, we will give you the forms to fill out when you arrive at our office.

 

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Menu

  • Home
  • Our Team
  • Our Services
    • Botox
    • Dermal Fillers
    • Microcannula Technique
    • Latisse
  • Before & After
  • FAQs
  • Forms
    • Medical History Form
    • Cosmetic Interest Questionnaire
  • Testimonials
  • Rewards
  • Free Consultation
  • Contact

Hours & Info

750 Old Main Street
Suite 200
Rocky Hill, CT
06067
860-266-0150
Call for an Appointment
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