If you live far from the office, or even if you just desire a preliminary consultation in the privacy of your own home, we would like to envite you to use our Virtual Consult.

Please fill out the information on this page to initiate the process. In order to have a meaningful discussion, we request that you submit high quality photographs for review. Please send a minimum of two photos of the area you wish to have evaluated, as well as a description of your surgical goals. After carefully reviewing your submission, our staff will set up a time for a telephone conference so you and and the doctor of your choice can discuss their expert opinion and recommendations.

Required fields have gold text.

We value your privacy! Your information will not be shared with anyone outside of our practice for any reason.

Title Select One Ms. Mrs. Mr. Dr.	Full Name
Email		Contact Phone
How would you prefer to be initially contacted? Email Phone
Age	Gender ---- Female Male	Height	Weight
Measurements
Areas of Concern
When are you hoping to have this procedure done? Please select a time frame: Within 1 Month 1-2 Months 3-6 Months 6 Months or more		Do you have a particular motivation? Please select: Wedding Birthday Public Appearance Job Market Class Reunion Family Reunion None of these
I would prefer my consultation to be with Dr. Michael Bogdan Dr. Mark Mason
Have you had cosmetic surgery before? Yes No If yes, please indicate surgical procedures:
Please submit your photographs in the following format:     - Use a solid background.     - Take one photo with the face or body centered and looking forward.     - Take at least one, preferably two profile photos. Example of frontal face view. Example of profile face view. Example of frontal body view. Example of profile body view.
Photo 1:		Photo 2:
Photo 3:		Photo 4:

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