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Photo Submission Consult

Thank you for your interest in a virtual consultation with Dr. Newall. We provide this virtual option for our out-of-town patients and those with busy schedules.

Virtual Check List:

Fill Out the Virtual Form & Upload Photos
Schedule Virtual Appointment
Complete Medical History in Patient Portal
Click Link for Virtual Appointment

Fill Out the Virtual Form & Upload Photos

Please submit within the virtual form include your images (reference the photo guide below). Please wear a bra and panties/bikini bottoms. If you are interested in breast procedures please do not wear a bra in images. Include FRONT VIEW, SIDE VIEW, BACK VIEW. You will answer a few questions to help us better understand your concerns and goals.

Schedule Virtual Appointment

Once we receive your virtual form we will reach out to you to schedule your virtual appointment unless you already have one scheduled. The virtual consultation fee is $100 and will be collected during the time you schedule your virtual appointment. This consultation fee will go towards your procedure if you choose to proceed with surgery.

Complete Medical History in Patient Portal

The medical history form will be emailed to you at the time we schedule your appointment. Please complete all sections of your medical history in the patient portal.

Click Link for Virtual Appointment

You will receive a link via email/text message to join the TeleHealth Meeting.

Please write down all questions you may have for Dr. Newall so they can be discussed during your appointment. If you have trouble uploading images or have questions about the form please email our virtual coordinator directly at sarah@acps.com

Español:

Formulario de consulta virtual

Gracias por su interés en una consulta virtual con el Dr. Newall. Complete este formulario por completo e incluya sus imágenes. Una vez que recibamos su formulario, nos comunicaremos con usted para programar una cita virtual. La tarifa de consulta virtual es de $100 que se cobrará durante el momento de la reserva. Esta tarifa se aplicará a su procedimiento si elige continuar con la cirugía.

Escriba todas las preguntas que pueda tener para el Dr. Newall para que puedan ser discutidas durante su cita.

¡Esperamos contar con su presencia!

Photo Submission Consult

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First Name(Required)

Last Name(Required)

Age(Required)

Gender

Weight

Height

Phone(Required)

Email(Required)

How would you like us to respond?

Phone

Areas of Concern & Procedures You are Considering:

When are you hoping to have this procedure done?

Is there an event that is motivating you?

Have you had cosmetic surgery before?

Yes

If yes, please indicate surgical procedures

How long have you been thinking about cosmetic surgery?(Required)

On a scale of 1-10, how important is this surgery to you?(Required)

What are your expectations & concerns of this procedure?(Required)

Where are you in your decision-making process?(Required)

PLEASE USE THE UPLOAD BUTTON BELOW TO UPLOAD PHOTOS TO SEND TO US

To make the most 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: 1. Use a solid background. 2. Take one frontal photo with the face or body centered and looking straight. 3. Take at least one, preferably two profile photos.

Photo 1(Required)

Accepted file types: jpg, png, jpeg, Max. file size: 5 MB.

Photo 2

Accepted file types: jpg, png, jpeg, Max. file size: 5 MB.

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I agree

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