Plastic Surgeon Daniel Ronel, M.D. New Patient Forms

New Patient Forms

If you would like to save time at your appointment, please download these forms and fill them out before your arrival.

Patient Information Sheet
Medical History
Privacy Notice
Photo consent
Cosmetic Interest Questionnaire
Patient Electronic Communications

Rewards Program

We have a Rewards Program! Click here to check your balance.

It's a way to thank you for your business, support, and referrals.

How It Works:
You will receive 5 points for every dollar you spend on services and products every time you visit. You can then redeem those points for aesthetic services and, if you are a good candidate, for surgical services.

How to Earn Points:
5 points per $1 spent (before tax)
250 points for signing up
250 points for referring someone to our practice
1000 points for referring someone who signs up for a procedure
And more ways coming . . .

How to Find Out How Many Points You Have: After you register, we will send you an email with your account number. Then, come back to this page and click on the link at the top of this form. Enter your number in the box, and voila!

What can I get for my points?

Please fill out this form to register for our Rewards programs:

Redeming Points

10,000 5% off an aesthetic service
20,000 10% off an aesthetic service
30,000 Botox at $12/unit (normally $15/unit)
40,000 Botox at $10/unit (normally $15/unit)
50,000 5% off a plastic surgery procedure
60,000 10% off a plastic surgery procedure
More ideas coming!

Rewards Program Details

Thank you for joining our rewards program!
You have just won 250 points!

Other ways to earn points:

5 - For each $1 spent (before tax)
250 - Internet sign-up
250 - Referring a patient
1,000 - Referring a patient who enrolls in a service
More ways coming soon!

Click here to check your balance.

Out-of-Town Patients

Our practice treats patients from all over the country, from New York to California to Alaska. The differences in time zones may make it easier to communicate by e-mail to obtain preliminary information from our office. We are able to render a medical opinion if furnished with suitable photographs of the area of interest. These can either be sent to us by FedEx or similar service, or by computer using digital images. Our e-mail address for images is info@danielronelmd.com.

Facial photographs should include front and side views as well as a close-up view of the eyes. Breast photographs should include a front view and an oblique view of each side (45 degrees from the front) with hands loosely clasped behind the back. Abdominal views, front and side, should include the entire abdomen from the bottom of the breasts to the thighs. Liposuction views should extend from the navel to the knees and include front and back views.

Accomodations and Spas

New Mexico is recognized as a unique environment for spiritual and physical healing. Santa Fe and Albuquerque have several excellent hotels with spa facilities for those patients who would like to convalesce with gentle therapeutic treatments. Dr. Ronel has approved postoperative treatment plans for each type of surgery. Convalescent room and/or spa packages are available at special rates for our patients.

In Santa Fe:
Encantado Resort

In Albuquerque:
Tamaya Resort and Spa

Private Care

Private nursing care in a lovely bed and breakfast is available outside of Albuquerque at The Plum Tree Inn. The Inn is owned and operated by Mary Daitz, RN, a nurse with 25 years of experience caring for patients postoperatively. Services provided include: