Priority Scheduling – Paris Surgical Specialists

Priority Scheduling for Cosmetic Breast Surgery

Welcome to the Priority Scheduling Manager for your Cosmetic Breast procedure at Paris Surgical Specialists. By filling out our questionnaire you will be put on our express track to your consultation and receive Priority Scheduling for your Breast Enhancement.

Your Name (required)

Your Email (required)

Your Phone Number (required)

Women with C cup or larger natural breasts often develop droop & sag over time that requires breast lifting. Women who have smaller breasts or simply lost volume and cleavage after pregnancy can usually get good results with Breast Augmentation alone. Select the situation that best describes you. Don't worry if you are unsure, we will sort it out for you in your consultation. (required)

What is your ideal consultation date to discuss Breast Enhancement? (required)

What is your ideal Breast Enhancement surgery date? (required)

Height (feet & inches) (required)
Weight (pounds) (required)
Current Bra Size (required)
Have you taken diet pills in the last 2 weeks? (required)YesNo
Have you breast fed or given birth in the last 3 months? (required)YesNo
Your preferred payment method: (required)

Anything else would you like for us to know?

YOUR PRIVACY MATTERS TO US: By Pressing Send you will initiate an email communication with Paris Surgical Specialists and you agree that e-mail communications are acceptable to you. Paris Surgical Specialists does not share your information with outside parties in any way and your privacy is part of our mission. If you have any concerns, issues, or reservations about making the above request via unencrypted email you can always choose to contact us by phone at 731-644-3211 during normal business hours. This information and your options are provided in accordance with HIPAA guidelines.