Welcome to our Online Consult Contact Form! Fill out your information and one of our awesome Medilaser Team Members will contact you with consult dates to choose from. Please note all inquiries past 4pm will become priority the next business day AM. We look forward to seeing you!

First Name

Last Name

Email

Phone

Birthday

What type of service are you interested in?

Check the category that applies:

• FACE/SKIN
• BODY
• VEIN REMOVAL/TREATMENT
• FAT TRANSFER
• FOR MEN
• MEDISPA BOTOX/FILLERS
• LASER FACIALS
• LASER HAIR REMOVAL
• TEETH WHITENING
• HAIR TRANSPLANT (Virtual Consult on Thursdays)

How did you hear about us?

Check the one that applies:

• Medilaser Email Blast
• Facebook
• Instagram
• Yelp
• Google Search
• HealthGrades®
• CitySearch
• Vitals
• Doctor.com
• Referral from Medilaser Influencer

Please note: We provide our Hair Transplant Consults virtually via phone, zoom, and/or Facetime every Thursday.

Our Medilaser Hair Specialist, Jessica, will be your virtual consultant. We look forward to speaking with you!

For Virtual Hair Transplant Consultations we need 2 pictures (Top of head facing forward and applicable graft donor areas)

Upload your hair pictures here

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Were you referred by a friend? If so, please list their name:

If you selected Google Search, may we ask what words you typed in the google search bar to find us?

What day is your best day for a Consult?

Please check the time slot that best fits your schedule.

• Weekdays (M-F) - Morning 8am-12pm
• Weekdays (M-F) - Afternoon 12pm-5pm
• Flexible/As soon as possible
• Saturdays - 9am-2pm (open one Saturday per month)
• Hair Transplants (Virtual Consult on Thursdays)

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Thank you for contacting us!

Thank you for contacting Medilaser, Cosmetic Surgery and Vein Center!

We’ve received your message and a member of our team will be in touch with you shortly. Whether you’re inquiring about cosmetic procedures, vein treatments, or skincare services, we’re here to help you feel confident and cared for every step of the way.

If you are suddenly unable to make your appointment, please call our office at (469) 362-8665 and someone will be happy to assist you. We understand things come up that might prevent you from making your appointment. You can review our full cancellation policy on this page.

We look forward to connecting with you!

— The Medilaser Team

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