Las Vegas Plastic Surgery: Jeffrey J. Roth M.D. F.A.C.S.
6140 S. Fort Apache Road, #100
Las Vegas, NV 89148
Phone: (702) 450-0777
Monday–Friday: 9 a.m.–5 p.m.
Patient Forms
Take advantage of our online Patient Packets and save time! Click here now to download our Patient Information, Health History, Financial Policy, and Photographic Authorization and Release Forms.
NOTE: Our downloads require Adobe Acrobat® Reader. If you need to download a copy, click here.
Cancellation & “No-Show” Policy
We require 48 hours notice for cancellations or requests to change your appointment.
A valid credit card is required at the time of scheduling your appointment. This is to hold your appointment only, and will not be charged. If you fail to give 48 hours notice to reschedule, cancel, or “no-show” to your appointment, your credit card on file will then be charged a $50 fee for your consultation.
If you arrive more than 15 minutes late to your appointment, we cannot guarantee that you will be seen by the doctor, as this will cause a delay in the next scheduled patients and it may be considered a “no-show”.
Contact Our Office to Learn More
If you have any questions about our forms and policies or need assistance, please contact us online or call (702) 450-0777 .