Please complete the assessment below and click submit.

Personal Information

Medical and Surgical History

Which of the following treatments are you enquiring about?

Medication, Lifestyle and Exercise

Photos and Acknowledgement

Please Note

In order for us to do a proper assessment - it is strongly advised that you include photographs to this enquiry.

What if I am not based near The Face and Body Place?

A consultation with our doctor is required to evaluate your requirements and overall health status. We will then guide you with recommendations and a treatment protocol suited to your needs. We offer on-site consultations as well as virtual consultations (Zoom, Skype, WhatsApp or by telephone) no matter where you reside.

What will Treatments cost me?

At the time of consultation, we will assess your requirements and provide a quotation for treatments, products and any ancillary costs. Our administrative team can also assist with financing options if these are required. You may click here to be redirected to the MediFin web page. MediFin offers financing options that may suit your needs.

All information contained in this form is and will always be kept strictly confidential. We do not share any personal information with any other entity, under any circumstances.

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