Burton Medical Group

Aesthetic
Intake Form

Complete the form below

Once the form is submitted, we will contact you as soon as possible.
Please answer all of the following questions
Disclose any history of heat urticaria, diabetes, autoimmune disorders or any immunosuppression, blood disorders, cancer, bacterial or viral infections, medical conditions that significantly compromise the healing response, skin photosensitivity disorders, or any other condition or illness.
Also disclose any history of vitiligo, eczema, melasma, psoriasis, allergic dermatitis, any diseases affecting collagen including Ehlers-Danlos syndrome, scleroderma, skin cancer, or any other skin condition.
Looking and feeling your best starts here
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Who We Are
Burton Medical Group

We are a small but busy medical practice that has been in business for over 25 years. We currently see patients who are 18 years or older. We are wanting to expand our business and move into aesthetic services and private label skincare products.

Macon, GA
  • Hours:
    Mon - Thurs: 9am - 5pm
  • Fri: 9am - 12pm
Warner Robins, GA
  • Hours: Thurs: 9am - 1pm
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Subscribe To Our Newsletter
Who We Are
Burton Medical Group

We are a small but busy medical practice that has been in business for over 25 years. We currently see patients who are 18 years or older. We are wanting to expand our business and move into aesthetic services and private label skincare products.

Macon, GA
  • Hours:
    Mon - Thurs: 9am - 5pm
  • Fri: 9am - 12pm
Warner Robins, GA
  • Hours: Thurs: 9am - 1pm
Follow us on Facebook
Facebook
Products
Shop
Subscribe To Our Newsletter
  • 2023 Burton Medical Group
  • 2023 Burton Medical Group