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Form: Short Initial Form – Step One

Home/Form: Short Initial Form – Step One

Form: Short Initial Form – Step Onekodrant2022-04-15T18:18:07+00:00

STEP ONE

Please fill the form below.
After you submit your data and uploaded image files, you will be redirected to confirm the personal information by signing legal document.

Your Personal Information

Name *

First

Last

Phone *

Email *

Your Residence (City & State)

Address Line 1

City

State

Zip Code

Plastic Cosmetic Surgery Procedures

Please select surgery procedure you are interested in

Face Procedures

Botox
Ear Surgery
Eyelid Surgery
Facelift
Neck Lift
Nose Surgery

Body Procedures

Hernia Repair
Tummy Tuck
Arm Lift
Brazilian Butt Lift
Body Contouring
Thigh Lift
Upper Body Lift
Mommy Makeover
Weight Loss Surgery

Breast Procedures

Breast Augmentation
Breast Lift
Breast Reconstruction
Breast Reduction
Male Breast Reduction

Select your doctor

Dr. Nick Masri
Dr. Mark Broudo

Additional Notes for the Doctor:

Photo Uploads for Evaluation

Please submit recent photos of the area that you would like to have evaluated. This usually consists of a front facing view, side view, and slightly turned view (3/4). If you are interested in a mermaid lift, Brazilian Butt Lift (BBL) or lower body lift or complete body contouring we require a full view of the back. If possible, please take photos against a solid background.

After this information has been received, our surgical coordinator will assist you with pricing and setting up your phone consultation with your surgeon should you decide to proceed.

Use buttons below to upload your image files.

* Your photo(s) are REQUIRED for evaluation purposes and will be kept strictly confidential.

Front View Image *

Click or drag a file to this area to upload.

Allowed image formats: JPG, JPEG, PNG. Max file size 5Mb

Side View Image *

Click or drag a file to this area to upload.

Allowed image formats: JPG, JPEG, PNG. Max file size 5Mb

Slightly Turned View Image

Click or drag a file to this area to upload.

Allowed image formats: JPG, JPEG, PNG. Max file size 5Mb

Full Back View Image *

Click or drag a file to this area to upload.

Allowed image formats: JPG, JPEG, PNG. Max file size 5Mb

Additional Image Upload

Click or drag a file to this area to upload.

Allowed image formats: JPG, JPEG, PNG. Max file size 5Mb

Your Availability

In order to schedule your consultation, please answer the following questions:

What you would most like to accomplish through this/these procedures? *

Please describe your expectations in the text box below

Please describe your current situation *

Want to learn more if these procedures are a good fit for me
Checking if I can afford the pricing
Prepared and ready for my surgery
Need my surgery ASAP

Please select one option that best describes your current situation

To learn more about your options, please visit our website articles at Face+Body BLOG.

You may find some body transformation results in our image gallery:
Face+Body Before/After Picture Gallery

Follow our Instagram Account where we post many more recent before/after images with descriptions: @facebodycosmeticsurgery

PLEASE NOTE: We do all major surgeries in the hospital environment only. The prices include Hospital, Anesthesia, Overnight Stay, Implants and Professional Fees.

CLICK HERE FOR BASIC PRICING INFO

IMPORTANT

After submitting the Step One form, you will receive an email from us, requiring that you confirm the surgery procedures you are interested in.

It is important that you reply to that email!

It also serves as your email address confirmation, in case anyone else submitted your data, or you had anything selected by mistake. We will continue with the process only after you reply to our email message.

Our virtual (phone) consultations take place on Wednesdays and Thursdays, between 9 AM to 5 PM EST.

How soon do you plan to have your surgeries? *

Let us know your preference

IMPORTANT

After submitting the Step One form, you will receive an email from us, requiring that you confirm the surgery procedures you are interested in, and accept the medical intake over the phone call.

It is important that you reply to that email!
It also serves as your email address confirmation, in case anyone else submitted your data, or you had anything selected by mistake. We will continue with the process only after you reply to our email message.

Thank you!

More information about Face+Body Cosmetic Surgery:

Click to go to Facebody.net website

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