BEVERLY HILLS CENTER
436 N. Roxbury Drive, Suite 207
Beverly Hills, California 90210 MAP

t 310-271-5954
f 310-271-0539

e info@enhancemedicalcenter.com

* All indicated fields must be completed.
Patient Name :
*Email address :
Please leave us a phone number if you wish us to contact you by telephone:
What part of your body would you like addressed:
What specifically bothers you about the area, and how would you like it improved?

* If you would like a detailed evaluation of a facial feature, please post your photos at a photo sharing website such as http://www.photobucket.com and send us the link to your photos. There should be a front view (top of head to bottom of neck) and a profile. If it is for nose or cheekbone surgery, please include a view with your head tilted back showing the bottom of your nostrils. Please note that most photo sharing websites are not encrypted.
Link to your photos on photo sharing website :
Would you like to know the cost of the procedure in the reply?
Yes No
How did you hear of us?
When are you planning to have surgery? (mm-dd-yyyy)
May we use your comments on our website, with your identity erased?
Yes No
 
 
 

 

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