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7777 Forest Lane, Suite C-230, Dallas TX 75230 • 972-566-2010

Virtual Consultation

 

To honor COVID-19 social distancing and accommodate the busy schedules of our patients, we now offer Virtual Consultations by phone and video conference via Zoom.

To get started, please complete the form below, including a description of your surgical goals and 2 photos of the areas that you want to focus on. Our specialists can then assess which procedures may offer the best results.

In the form below, you may also request a Video Consultation with our staff via Zoom to confidentially discuss questions, concerns, and treatment plans, all from the safety and comfort of your home.

All information you provide is confidential. We do not share your data to any person or organization outside of our office.

 

Required fields are marked with an asterisk *.

Your Name*

Telephone*

Height

What procedure(s) are you interested in?*


Breast AugmentationBreast LiftBreast ReductionGynecomastiaFaceliftRhinoplastyBlepharoplastyEar SurgeryChin SurgeryForehead LiftNeck LiftLiposuctionTummy TuckMommy MakeoverLabiaplastyLaser ResurfacingBBL / PhototherapyAcne TreatmentBotox / DysportDermal FillersOther (Explain below)

Body Areas of Focus

Have you had cosmetic surgery before?* YesNo

If yes, please indicate which procedures:

How would you like us to reply?* EmailPhone

 

Video Consultations

Video Consultations are available upon request. Would you like us to reach out to schedule a video consultation?* Yes, By EmailYes, By PhoneNo, Do not contact me for a video consultation

 

If you have some photos of yourself that you would like us to review, please use the upload buttons below to send them to us. For best results, click here for guidelines and examples.

Frontal View:

Side View:

Accepted file types: jpg, png, pdf.
Max upload size 5MB.

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Secured

Terms of Use

This form is encrypted and all of your information is securely transmitted to us via encrypted email. However, the use of any electronic communication system carries risks. We cannot guarantee the security of your information once it is received and decrypted by our office. Using the Internet and email for your consultation is for your convenience only, and by using them you assume the risk of unauthorized use.

By checking the Acceptance box above, you hereby agree to hold Dr. Antonetti and his affiliates harmless from hacking or any other unauthorized use of your personal information by outside parties.

Using a solid background, take one frontal photo with your body or face centered and facing forward.

Using the same solid background, take one side view with your body or face centered and facing to the right or left.

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