Breast Augmentation Seattle | Breast Implants Bellevue

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Dr. Gottlieb

Breast Surgery

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Questions about Breast Augmentation?

Visit our website dedicated to information on Breast Augmentation. Find more information about breast implants, breast augmentation recovery, fat grafting to the breast and costs.

breastlift-seattle.com

Schedule a Consultation

You may use this form to request a surgery consultation with Dr. Gottlieb or a non-surgical encounter with any of our professional providers. For cosmetic surgery consultations with Dr. Gottlieb there is a fee of $75, which is fully credited toward any surgical procedure you choose to have. This fee is paid at the time of scheduling either by calling our office with your CC information or by using Paypal . Alternatively you may schedule a no charge cosmetic surgery consultation with Julie Legman, our patient care coordinator.

If you are interested in non-surgical treatments (such as Botox, laser treatments, filler injections), your provider will conduct an initial consultation and recommend appropriate treatments. Naficy Rejuvenation Center is nationally recognized for expertise in non-surgical treatments and all patient encounters are supervised by a medical doctor or a nurse practitioner.

Dermatology visits are conducted by Maria Imbesi, PA-C and typically billed to your insurance. Common dermatology conditions treated include moles, cysts, skin cancer, acne, and rashes.

After receiving your contact information, desired days or dates, and desired time frames, we shall contact you to notify you of available dates and times for your consultation visit.

First Name:

Last Name:

Address:

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Day time phone:
Evening phone:

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Schedule your appointment with:

	Dr. Gottlieb Breast & Body Plastic Surgery $75 consultation fee (Requires pre-payment by Paypal or by calling office with CC)
	Julie Legman, PCC Consultation times are offered Mon thru Fri No charge
	Maria Imbesi, PAC Dermatology visits offered M,W,F Billable to insurance
	Non-Surgical Consultation Consultation times are offered Mon thru Fri No charge

Date and Time of Appointment:

First Preference:
Date: Time:

Second Preference:
Date: Time:

Third Preference:
Date: Time:

How soon are you considering having the procedure(s) performed?

I would like to have the treatment on the same day as the
consultation
I know exact time frame
Dates: From To
Within few weeks
Within few months
Within a year
Unsure/Just considering my options

Type of service(s) you are considering:
(check all that apply)

Lipo Augmentation of Breast

Breast Augmentation

Saline Breast Implants

Silicone Breast Implants

Breast Reduction

Breast Lift (Mastopexy)

Breast Revision

Breast Cancer Reconstruction

CoolSculpting body contouring

Liposuction of Arms

Liposuction of Abdomen

Liposuction of Back

Liposuction of Flanks

Liposuction of Thighs

Liposuction of Knees

Male Breast Reduction

Arm Lift

Tummy tuck

Mini Tummy Tuck

Thigh lift

Buttock Lift

Lower Body lift

Body Fat Grafting

Body Skin Cancer

Body Scar Revision

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