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Home / Virtual Consultation Form

Virtual Consultation Form





How would you like us to respond?

Do you prefer AM, PM, or any?




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

File formats accepted: gif | png | jpg | jpeg
File size limit: 3mb

By checking this box you agree to the Terms of Use listed here*
You must be 18 years or older to have a virtual consultation*

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