Photo Consultation

Submit your photos and information for Dr. Marshall to review and someone from our office will be following up with you shortly.

First Name *

Last Name *

Phone *

Email *

Address *

City *

Postal code *

State *

Procedures of Interest (select all that apply): *

Liposuction

Brazilian Butt Lift (BBL)

BBL Revision

Rib Remodeling

Tummy Tuck

Breast Augmentation

Fat Transfer to Breasts

Breast Lift and/or Reduction

Avéli Cellulite Treatment

Body Lift

Brachioplasty

Labiaplasty

Areas of Concern (select all that apply) *

Stomach

Buttocks and/or hips

Back

Breasts

Thighs

Face

Date of Birth (MM/DD/YYYY): *

BMI Calculator

Height ( Feet )

4

5

6

Height (Inches)

0

1

2

3

4

5

6

7

8

9

10

11

12

Weight lbs

Height *

Your BMI is

Upload your photos below:

Please take photos in your bra and low-cut underwear, or you may choose to take them nude or wearing a low-cut bikini. Ensure that your full stomach is visible in the photos. If you are interested in a breast procedure, please take photos without a bra, and your breasts should be clearly visible.

Right Side View Photo *

Front View Photo *

Left Side View Photo *

Back View Photo *

Do you smoke? (select all that apply) *

No

Yes, cigarettes

Yes, vape

Yes, THC

Yes, other

Surgical History and Approximate date *

Past and Ongoing Medical Problems *

Heavy menstrual bleeding/diagnosed blood disorder *

Yes

No

Anemia *

Yes

No

Approximate date you would like your surgical procedure? *

All Medications *

Occupation

Number of Children and Ages *

Instagram Handle

Any additional information you would like to share:

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

Please review your form and ensure that your email and phone number are correct. Incorrect information will result in no response.