Virtual Screening

Our Virtual Screening Process

Begin your journey to enhanced confidence with our convenient virtual screening process.

To help our doctors determine if you are a good candidate for surgery, we ask that you upload 4 photographs of the area you’d like to improve using the contact form below. Additionally, please include a brief description of your surgical goals and the results you hope to achieve.

Our doctors will carefully review your submission. If you’re a suitable candidate for surgery, our patient care coordinator will reach out to you with your doctor’s evaluation and guide you through the next steps.

Your Information

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

Required fields are marked with an asterisk *.

    *

    What type of results are you hoping to achieve?

    Have you had cosmetic
    surgery before?

    If yes, please indicate surgical procedures:

    How would you like us to reply?

    If you have some photos of yourself that you would like to share, please use the upload button below to send them to us. For best results:

    • Use a solid background.

    • Take one frontal photo with your body or face centered and facing forward.

    • Take one or two side views with your body or face centered and facing to the right and/or left.

    Example of a good photo

    Example frontal view.

    Example of a good photo

    Example frontal view.

    Example of a good photo

    Example side view.

    Example of a good photo

    Example side view.





    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 this box you hereby agree to hold Dr. Clark and her affiliates harmless from hacking or any other unauthorized use of your personal information by outside parties.