Patient History

Through this form share you can share your medical history with me.

We are here to offer you personalized service that adapts to your aesthetic and functional needs. Please complete this form so we can provide you with a detailed and accurate evaluation.

Our team will carefully review your information to give you the best possible guidance. Once you submit your responses, we will get in touch with you to schedule your consultation and clear up any questions you may have. Our commitment is to offer you high-quality care with a professional and safe approach.