top of page

 Patient Forms 

New Patient Form

All new patients (except Dysport), please fill this form out prior to your appointment.

Dysport Patient Form

All new Dysport patients, please fill this form out prior to your appointment.

Aspire Rewards Account

(for Dysport Patients)

Create an Aspire Rewards account and receive $20 off of each treatment (every 3 months)

Consent Forms  

Please click here to access our consent forms. We will have you sign a consent at your appointment but have them available here to read. They contain important information about contraindications and possible side effects. 

Dysport Instructions

Please click here for pre and post instructions for Dysport Injections. 

Personal Nurse Liaisons, LLC

Subscribe Form

emmybakernp@gmail.com

phone: 502-702-3834

fax: 502-890-2771

Louisville, Ky 40207

©2019 by Personal Nurse Liaisons. Proudly created with Wix.com

bottom of page