From the convenience of your home, please answer a few questions about yourself with our complementary HIPPA-compliant online consultation.
Please upload 3 images with your arms down at your side with a solid background. It is required that someone else take these photos for you.
If you would like to schedule a traditional in-office consultation please contact the office at (405) 842-6677.
Name (First & Last)

Date of Birth

Phone #

What procedure are you interested in?

What are your surgery goals?



How did you hear about us?

Front Image (straight on, arms at sides)

Side Image 1 (arms at sides)

Side Image 2 (arms at sides)

Thank you for your interest in our practice.
We look forward to working with you !!
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