Below are pdf file versions of our registration documents. These include a two-page registration form, a copy of our payment policies for elective procedures and the HIPAA (Health Insurance Portability & Accountability Act of 1996) form. If you wish, you may print these at home, fill them out and bring them in with you to your initial appointment. You will need Adobe Acrobat Reader, which is free, or another similar program.

Registration Page 1	Registration Page 2
Payment Policies	Privacy Practices

Breast Augmentation .  Tummy Tuck / Abdominoplasty .  Liposuction
IPL Photorejuvenation .  Crystal-Free Microdermabrasion .  Laser Hair Removal
Winds of Change True U Skin Care Products . Other Links .  FAQs
Botox .  Juvéderm .  Radiesse .  Restylane & Perlane

Winds of Change Cosmetic Surgery Specialists
12827 Jones Road
Houston, Texas 77070
Email: info@drsumpter.com
Phone: 281-894-9990
Fax: 281-894-9993