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11820 Northup Way, Suite E190 Bellevue, WA 98005
Mon. - Thur. 9 a.m. - 5 p.m.
By providing your mobile number, you consent to receive HIPAA-compliant text messages from our practice via Weave. Scheduling and rescheduling requests are handled via text only to 425-450-1994. DATE OF BIRTH:*
PROCEDURE OF INTEREST*Breast (Augmentation / Lift / Reduction)Body (Liposuction / Tummy Tuck/ Gynecomastia/ Body LiftFace (Facelift / Neck Lift/ Fat Grafting)LabiaplastyGoldIncisionWeight Loss / Hormone Replacement TherapyOther
BUDGET*Under $10,000$10,000 – $20,000$20,000 – $30,000$30,000+
FINAL DISCLAIMER:*
By submitting this form, you acknowledge and agree to the following:
-The consultation fee is non-refundable -A minimum of 48 business hours’ notice is required for rescheduling -Only one reschedule is permitted -Missed or late-cancelled appointments will result in forfeiture of the consultation fee -All communication regarding scheduling will occur via HIPAA-compliant text messaging
Please read about what to expect at your consultation.
