Forms

New Patient Forms-required for all new patients.
Click here to download a New Patient Form

Breast Summary-required for all breast surgery patients.
Click here to download a Breast Summary Form

Consent Forms:
Click here to download a Dysport Form
Click here to download a Restylane/Perlane Consent Form

High Plains Plastic & Reconstructive Surgery, PA
Northwest Texas Professional Building • 3501 Soncy Road, Suite 1001 • Amarillo, Texas 79119 • 806-242-2001

Dr. T. Michael Dixon, certified by the American Board of Plastic Surgery, is dedicated to excellence in plastic surgery, reconstructive surgery and cosmetic surgery. Specializing in: breast
augmentation, tummy tuck, body lift, arm lift, thigh lift, post bariatric/gastric bypass surgery, liposuction, breast reduction, breast reconstruction, face lift, eyelid surgery, body lift, chemical peel,
Botox®, Restylane® and ear surgery. Located in Amarillo, Texas the office serves patients from surrounding cities such as Lubbock, Oklahoma City, Albuquerque, and Wichita Falls.

Marketing by Perfect Yourself a breast augmentation, tummy tuck and liposuction resource.

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