Luxe Aesthetics

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Raleigh 919-443-2557
Cary 919-443-2557
Greensboro 336-443-9300
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  • About Us
  • Services
    • Services Overview
    • Surgical
      • Eye Condition
        • Droopy Eyelids
        • Eyelid Lumps and Bumps
        • Eye Socket Orbital Disorders
        • Eyelids Turning In or Out
        • Watery Eye and/or Tear Duct Surgery
      • Face Fat Transfer
    • Non-Surgical
      • Chemical Peels
      • Injectables
        • Botox
        • Juvederm Voluma XC
        • Restylane
        • Xeomin
      • Laser Treatments
      • Microneedling
      • Non-Surgical Facelift
      • Platelet Rich Plasma (PRP) Injections
  • Before & After
  • Fillers & Botox on Demand
  • Patient Resources
    • Patient Portal
    • New Patient Forms
    • Preoperative and Postoperative Information
    • Practice Policies
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New Patient Forms

Filling out forms is never fun! Save yourself some time, energy, and hassle on the day of your first patient
appointment by filling them out in advance and bringing them with you.
If you have any questions, call us and we will assist you.
Our Cary and Raleigh offices can be reached at 919-443-2557.
Our Greensboro office can be reached at 336-443-9300.

New Patient Forms

New patient appointments usually take 30-45 minutes, depending on your specific condition. For your convenience, we have attached our new patient packet below. All forms in the packet below can be completed on our Patient Portal with the exception of our New Patient Information form. If possible, we ask that you sign up for a portal account and sign our policies on the portal, but if you are unable to do so please print the new patient packet below and bring a completed copy to your appointment.

New Patient Packet

The New Patient Information form can be printed from the portal or from the link below.

New Patient Information

By filling out the new patient packet ahead of time, you will save significant time at the beginning of your visit. If you have any questions about accessing the patient portal or filling out the new patient packet, our team will be happy to assist you. After your appointment, there may be additional forms to fill out and sign as well.

What to Bring to Your Appointment

  • Completed forms
  • Insurance cards
  • Driver’s license

We participate with most major insurance plans. If we participate with your insurance, applicable consultation fees will be billed to your insurance and you will be expected to pay deductibles, co-insurances, copays, and any non-covered services. You will be expected to pay any copays at the time of service. For cosmetic or self-pay patients, payment for the initial consultation is expected in full at the time of the visit. We accept cash, checks, Discover, MasterCard, and Visa. We look forward to meeting and assisting you with your oculofacial plastic care!

Physician Referral Forms

For doctors’ offices requesting a consultation, please download and complete the Referral Form and fax it back to us at 919-869-1869.

Luxe Referral Form

For the convenience of their patients, Dr. Renzo Zaldívar and Dr. Tal Rubinstein are accepting new patients in our Cary, Raleigh, and Greensboro locations.

**Please note, at this time, patient forms cannot be submitted through this website. Patient’s please PRINT these forms and bring them with you to your appointment**

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Recent Posts

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Recent Posts

  • What Does PRP Therapy Treat?
  • Xeomin FAQ: How Soon Will You See Results?
  • Experience These Amazing Microneedling Benefits Today
  • How Does a Face Fat Transfer Work?
  • What Can a Chemical Peel Do for Your Skin?

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    Oculofacial & Plastic Surgery Consultants

    Triangle Offices

    Cary Office
    3731 NW Cary Pkwy, Ste.101
    Cary, NC 27513

    North Raleigh Office
    8305 Falls of Neuse Rd, Ste. 204
    Raleigh, NC 27615

    Raleigh Office
    2501 Atrium Dr, Ste. 150
    Raleigh, NC 27607

    Triad Offices

    Greensboro Office
    2018 New Garden Road, Ste. C
    Greensboro, NC 27410

    Winston-Salem Office
    2828 Maplewood Ave, Ste. B
    Winston-Salem, NC 27103

    Office Information

    Monday - Thursday: 8:00 am - 5:00 pm
    Friday: 8:00 am - 4:00 pm

    Billing Information

    Luxe Aesthetics
    P.O. Box 1027
    Morrisville, NC 27560

    Phone Numbers

    Triangle Phone
    (919) 443-2557

    Triad Phone
    (336) 443-9300

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