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Cairns Plastic Surgery

 

 


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This form allows Dr Hertess at Cairns Plastic Surgery to do a preliminary review of your case online. Please fill out the form to initiate this process.

We will review your case and contact you as soon as possible to go over your options. Thank you for contacting our practice.

Please note that Cairns Plastic Surgery is located in Cairns, North Queensland and this enquiry form is intended for persons genuinely intending to undertake treatment in Cairns.

 
Name:
E-mail Address:
Phone Number:
1. List in priority the things you would most like to improve about your image.
2. Have you had any previous cosmetic surgery? (If no, go to question #3)
a. What was the reason for your surgery?
b. When was your last surgery performed?
c. Who performed your surgery? (name of surgeon)
3. If you have not had another surgery, what are your realistic desires, i.e., What will/would it take for you to be satisfied with the outcome? Think about this and be honest.
 
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