Schedule Your Appointment Today by Calling (805) 434 2821

Patient Forms


In order to save you time filling out paperwork at our Templeton office, we offer the convenience of downloading patient forms right from our website and bringing them with you for your visit.


Patient Consent Form

Medication List

Nuevo Paciente Consentimentos

Aesthetic Questionnaire

Medical Release Form

Photo and Video Release Form

Privacy Policy Form


Fax Number: 805-434-2526

Let us know how we can further improve your treatment experience at Plateroti Dermatology!


Plateroti Dermatology
1101 Las Tablas Rd, Ste G
Templeton, CA 93465
Phone: 805-434-2821
Fax: 805-434-2526

Office Hours

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