Certified
American Board
of Plastic Surgeons
.: Candidate Evaluation

This form allows Dr. Edelson to do a preliminary review of your case online. Please fill out the form to initate this process.

We will review your case and contact you as soon as possible to go over your surgical options. Thank you for contacting our practice.


Please answer all questions
*Patient Name:
*E-mail Address:
Phone Number:
1. List in priority the things you would most like to improve about your image.
2. Have you had any previous cosmetic surgery? (If no, go to question #3)
a. What was the reason for your surgery?
b. When was your last surgery performed?
c. Who did your surgeries? (name of doctor and specialty)
3. If you have not had another surgery, what are your realistic desires, i.e., what will/would it take for you to be satisfied with the outcome? Think about this and be honest.



View Map
   
     

Dr. Edelson | Face | Body | Breast | Candidate | Home

Edelsonplastic.com is part of the DocShop network, a free online medical information resource where you can learn the latest information about rhinoplasty and breast lift surgery candidacy.

Copyright © 2003 Dr. Ronald J. Edelson M.D., All rights reserved. | Developed by Einstein Medical