Consultation Form

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NATURALLY NOTICEABLE®

Brian Hwang, MD FACS

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First name

Last name

Date of birth

Phone

Number of children

Are you pregnant?

Yes

Do you drink alcohol?

Yes

Do you smoke?

Yes

Occupation

if yes, what do you smoke?

Cigarettes

Vape

THC

Other

Street Address

City

Postal / Zip code

Street Address Line 2

Region/State/Province

Country

Instagram Username

Weight

Height

Past and Ongoing Medical Problems

All Medications

Please list any allergies

Have you had any of the following?

Liposuction

BBL

Coolsculpting

None

If yes to which area?

Surgical history

Which procedures are you currently interested in? (if BBL and/or Lipo, please specify which area bother you the most)

When approximately do you want your Surgical Procedure?

How did you hear about Dr.Brian Hwang?

Photo Upload

To optimize the quality of the photos, please follow these instructions :

- Take photos in a Bra and underwear or two peace bikini

- If interested in Breast procedure please take photo with no bra

- Stand in a well lit room

- Use a background like a door or a wall

- Position yourself 3-4 feet away from the camera

- Try to center the area of interest in the middle of the photo

Upload : Front View

Upload File

Upload supported file (Max 15MB)

Upload : Back View

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Upload : left Profile

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Upload : Right Profile

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