To schedule your cosmetic consult with Dr. Baroudi, simply fill out the form below.

The consult will be 30 minutes to an hour long, during which Dr. Baroudi will perform a medical examination, answer any questions or concerns you may have, show you before and after pictures, and recommend the best route to achieve your cosmetic goals. A member of our staff will give you a tour of our state-of-the-art facility, and you will leave with an accurate quote as to the cost of the procedure(s).

There is a $100.00 non-refundable fee for all cosmetic consults. This fee is not applied towards any surgical fees. For BOTOX® or RESTYLANE® consults, the $100.00 consult fee is waived only if treatment is performed at the time of consult.

Please note that the appointment requested using this form is of pending status. A staff member will contact you by phone at the number you provide below to confirm the appointment.

Use calendar to click a date. Crossed-out dates and weekends are unavailable.
Use calendar to click a date. Crossed-out dates and weekends are unavailable.

* Indicates Required Field

Selected Date: *
Desired Time of Consult: * Consults are 30 minutes to an hour long	Select Date From Calendar First...
First Name: *
Last Name: *
I like to be addressed (called) as: *
Phone Number (With Area Code):* Will be Used to Confirm Appointment
Phone Type: *	Choose one... Cell Phone Home Phone Work Phone
Best Time to Call: *	Choose one... Anytime Morning Afternoon
Email Address: *
Address 1:  *
Address 2:
City:  *
State:  *	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
ZIP Code: *
Consult Type: *
Face Lift   Liposuction   Eyelid Surgery   Tummy Tuck   Nose Reshaping   Forehead Lift   Breast Augmentation   BOTOX® Cosmetic   Breast Reduction   Restylane®   Breast Lift   Ear Surgery   Other (Please specify name of procedure)

Reason for Consult: *

Enter a brief description on what will be addressed during this consult.

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We gladly accept the following payment methods