Allura | Skin, Laser & Wellness Clinic

To expedite your visit, please save this fillable form to your computer and open it with Adobe Reader. Once you have completed the form, print a copy, initial where indicated and sign the last page. Please bring it with you to your next visit. If you do not have Adobe Reader, the form can be printed and filled out by hand.

For ALL Treatments, except Bio-Identical Hormone Replacement Therapy, please complete the GENERAL HEALTH HISTORY FORM:

General Health History Form

Also, please review the Allura Policies prior to visiting the clinic.

Allura Policies

Bio-Identical Hormone Replacement Therapy

If you are visiting Allura for Bio-Identical Hormone Replacement Therapy please print and fill out the pertinent forms found below. 15-20 minutes may be required to complete all the forms. Please bring the paperwork to your appointment.

Please contact our office for lab orders that may be taken or faxed to your local lab.

Female Bio-Identical Patient Forms

Male Bio-Identical Patient Forms

Named One of the Top Nationally Ranked Clinics for Allergan Products

Including Botox, Juvederm, Latisse & Skin Medica Products

Don't Take Our Word For It, Our Satisfied Clients Say It All

Check out the testimonials from our happy customers below *Individual Results May Vary and Results Are Not Guaranteed



VASERĀ® Shape is the newest technology in non-surgical body contouring. Smoothes, firms & contours the body* Reduces appearance of cellulite* See optimal results after 3-5 session* Call …Read More

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I have suffered with hot flashes every hour to 1/2 hour for eight years as I had to have a complete hysterectomy in 2004. I have not had a full night sleep since then because of the hot flas…Read More

Pat S.


Dear Dr. D, I wanted to send you and your staff some Kudos and say Thank YOU. Please feel free to use my words as a testimonial for what you do here in our community. Your initial consultati…Read More

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