Rousso Facial Plastic Surgery Clinic

Rousso Aesthetic Medical Spa
Alabama Hair Institute


The Mountain Brook Center

2700 Highway 280
Suite 300 West
Birmingham, Alabama 35223

Phone: (205) 930-9595
Toll Free: (877) 932-0400

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New Patient Consultation Form

Prior to your consultation, please complete our New Patient Consultation Form.

Click here to download our New Patient Consultation Form. Please fill out this form and either 1) bring a copy into our office at the time of your appointment or 2) email it to

*NOTE: Adobe Reader is required to download this form and fill it out electronically. Click here to download Adobe Reader.


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