Skip to content
Mon - Fri: 9:00 AM - 5:00 PM
5550 Friendship Blvd, Suite 110 Chevy Chase, MD 20815
(301) 951-8122
Facebook page opens in new window
YouTube page opens in new window
Instagram page opens in new window
Thesiger Plastic Surgery
Chevy Chase Plastic Surgery
GET A FREE CONSULTATION!
301-951-8122
Home
About Us
Meet Dr. Thesiger
Our Pratice
FAQ
Financing
Procedures
Body Procedures
Breast Procedures
Facial Procedures
Carboxytherapy
Microneedling
Laser Treatments
Virtual Consultation
Gallery
Testimonials
Contact
Search:
SEARCH
Home
About Us
Meet Dr. Thesiger
Our Pratice
FAQ
Financing
Procedures
Body Procedures
Breast Procedures
Facial Procedures
Carboxytherapy
Microneedling
Laser Treatments
Virtual Consultation
Gallery
Testimonials
Contact
Virtual Consultation
You are here:
Home
Virtual Consultation
Please fill out the form below to schedule a Complimentary Virtual Consultation
Title:
Mr.
Mrs.
Ms.
Dr.
Name
*
First
Name
Age:
Gender:
---
Male
Female
Non Binary
Height:
Weight:
Email:
*
Phone:
*
How would you like us to respond?
*
Email
Phone
Areas of Concern & Procedures You Are Considering:
*
When you hoping to have this procedure done?
*
Please select one
Within 1 Month
1 - 2 Months
3 - 6 Months
6 Months or more
Is there an event that is motivating you?
*
Please select one
Wedding
Class Reunion
Family Reunion
Birthday
None of these
Have you had cosmetic surgery before?
*
Yes
No
If yes, please indicate surgical procedures:
How long have you been thinking about cosmetic surgery?
*
On a scale of 1-10, how important is this surgery to you?
*
What are your expectations of this procedure? What are your concerns?
*
Where are you in your decision making process?
*
How were you referred to Dr. Thesiger? - Please check all that apply
*
Friend
Another Doctor
You have been a patient of ours
Radio
TV
Google
Facebook
Instagram
Please use the upload button below to upload photos to send to us:To make the most out of your virtual consultation, do your best to submit your photographs in the following format. This will allow our doctors to make the most comprehensive assessment.
Use a solid background.
Take one frontal photo with the face or body centered and looking straight.
Take at least one, preferably two profile photos.
Photo 1:
*
Photo 2:
Photo 3:
Photo 4:
Consent
*
By checking this box you agree to the Terms of Use listed here:
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.
By checking this box you hereby agree to hold Dr. Thesiger and affiliates harmless from any hacking or any other unauthorized use of your personal information by outside parties.
Go to Top
