Out of town__________________________

INFORMATION FOR OUT OF TOWN PATIENTS

Patients frequently travel from out of state to have surgery with Dr. Crofts. We make every effort to make this process convenient and easy. Dr. Crofts will need to consult with you at some point prior to your surgery. With out of town patients we try to arrange that within a few days before your surgery. In order to schedule surgery we will need a few things from you. In some cases for out of town patients, Dr. Crofts will require a consultation in person before scheduling surgery.

1- We will need you to fill out a few forms including the new patient form, the personal health history and the financial policy form. These forms are located in the forms tab here on our website. Please print them off, fill them out and mail them back to us with your pictures on a disk (you can also email the pictures-see below.) It is important to include if you are a smoker and what medications you are on. We require you to stop smoking 2-3 weeks prior to surgery and ask that you discontinue use of any aspirin or aspirin products at least 2 weeks prior to surgery.

2- We will need to have pictures of you to determine what procedures to schedule you for and what will give you your ideal results. You can send them through the mail on a disk with your forms or may email them to info@croftsmd.com. When emailing any information please state your full name, phone number and the procedures you are interested in.

TIPS FOR PICTURES

Breast photos- The frame of the pictures should be from below the chin to the hip bones or just a few inches below the belly button. The pictures should be set against a dark backdrop with good lighting.

Please send 6 photos- 1 straight on with both hands to your side, 1 straight on with both hands straight up in the air, 1 facing left and 1 facing right, 1 oblique facing left (angled towards the camera) and 1 oblique facing right (angled towards the camera).

Face photos- The frame of the pictures needs to be from the top of the head to the bottom of the neck. The pictures should be set against a dark backdrop with good lighting.

Please send 3 photos of your face…..front and both sides. If you are inquiring about other areas of the face for example the eyelids, please take close up photos.

Body photos- The pictures should be all areas requiring surgery. The pictures should be set against a dark backdrop with good lighting. Please send front, back and both sides pictures with your feet shoulder width apart and your hands place behind your head. Please wear thong underwear when taking body pictures. Please have the frame of the pictures below the breasts down to your feet and then also closer if lower legs are not included in surgery. For example, for a tummy tuck and liposuction of the hips, flanks, inner and outer thighs the picture needs to be from below the breasts to the knees front, back, and both sides with hands behind head.

3- We also need a list of the procedures you are interested in and a description of what is bothering you and what you would like to achieve through getting that surgery.

4- A 10% deposit is required to reserve a date for surgery.

5- We do have financing available through Capital One.

For your convenience, we have arranged for special guest rates with nice and reasonable hotels close to our office and close to the surgery center. Please tell the hotel when you call that you will be having surgery with Dr. Kimball Crofts. Listed below are the hotels and the names of the people that negotiated the special rates for our patients. Please plan to stay at least a week after surgery if possible. For major surgeries a longer stay may be beneficial.

SpringHill Suites Marriot in Lehi