STEP 1

Please fill out the Questionnaire and then continue to choose the date

for your Consultation with Gabi.

GENERAL INFORMATION

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PATIENT INFORMATION

Do You Smoke?
MEDICAL HISTORY
MEDICATION

PREGNANCY

PRIOR SURGERY

Procedure Of Interest

PROCEDURE OF INTEREST

UPLOAD IMAGES

If uploading images, please include a front view, side view and a bottom view. Please Note: No virtual consultation can be scheduled without photos.

Upload File
Max File Size 15MB
Upload File
Max File Size 15MB
Upload File
Max File Size 15MB
Upload File
Max File Size 15MB
Upload File
Max File Size 15MB
Upload File
Max File Size 15MB

"Now choose date for consultation with Gabi"

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Please contact us with any questions or to set up your appointment.