Date of Birth:

What is your height and weight?
ImperialMetric

Do you smoke cigarettes?
YesNo
How did you find us?

There is a $100 consultation fee that the office of Dr. Effie Politis will collect at the time of scheduling in order to secure a date & time for the appointment. If you choose to move forward with booking surgery after you have your consultation with Dr. Effie, that $100 will be applied towards the cost of your surgery.
I understand & will provide a form of payment when scheduling my consultation.I decline to pay the $100 & therefore will not schedule a consultation.