Virtual Consultation

Please complete the form below to schedule your virtual consultation. During your consultation, Dr. Tal will discuss your surgical goals and address any questions or concerns you may have.

First Name

Last Name

Phone Number

What type of results are you hoping to achieve?

Younger

Healthier

Cosmetic Correction

Height

Weight

Measurements

Age

Gender

How Soon

Please select an event

Procedure of Interest

Have you had cosmetic surgery before?

Yes

Please indicate the surgical procedures:

If you have photos of yourself that you would like to send us, please use the upload buttons below to upload photos: To make the most out of your virtual consultation, please try to take two profile photos and one frontal photo with the face centered and looking forward. Please also have a solid background. (jpg,png,gif)

Maximum file size: 23.07MB

Address

City

State

Zip/Postal

How did you hear about us?

Questions/Comments

I agree to the Terms of Use

I agree to the Terms of Use*

*By submitting this form you consent to receive phone calls, text messages and emails from Tal T. Roudner, MD, FACS Plastic & Reconstructive Surgery. It is not a condition of purchasing any goods or services. You can opt out at any time, message/data rates may apply, and opting-in includes acceptance of the Privacy Policy and Terms of Use. Communications through this website or via email are not encrypted and are not necessarily secure. Use of the internet or email is for your convenience only, and by using them, you assume the risk of unauthorized use.

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*Communications through our website or via email are not encrypted and are not necessarily secure. Use of the Internet or email is for your convenience only, and by using them, you assume the risk of unauthorized use.