Book with Dr. Rad

Thank you for your interest! To begin the process, follow these steps (fields marked with an asterisk (*) are required):

Please complete the entire form.
If you’ve had prior facial surgery and you seek revision of the same areas, then we must receive your other surgeon’s operative reports and before/after photos.
Please ensure that a complete information record is received. Incomplete records won’t be eligible for scheduling.
Your record will be reviewed in-depth. If deemed suitable for surgery then a consultation with Dr. Rad may be scheduled for 40 minutes, virtual or in-person. A $500 consultation fee confirms booking (credited back to surgical fees; follow up consultations incur additional cost.)

We look forward to hearing from you!

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

1. PROCEDURES & INTERESTS

Procedure 1

Procedure 2

Procedure 3

Procedure 4

Procedure 5

Procedure 6

Describe what about your features bother you and why? **

How did you hear about us?*

Select the item that best describes your primary interest*

Other*

2. DEMOGRAPHICS

Name*

First Name* Last Name*

Date of Birth*

Age*

Email**

US Phone*

International Phone

Address*

Street Address Apartment City State Zip Code Country

3. PAST AESTHETIC HISTORY

Have you had any previous surgeries?**

yes

Please list any prior procedures including: Date of surgery, prior surgeon, any issues with prior procedures, and any pertinent information*

If you have had prior facial surgery and you want revision of the areas previously treated, then we need your complete medical records including operative reports and before/after photos.

Have you had prior face surgery?**

yes

Do you want a revision of the area previously treated?**

yes

if yes, then upload operative reports**

Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 50 MB.

before/after photos from prior procedure(s)**

Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 50 MB.

medical records from prior procedure**

Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 50 MB.

4. PHOTOS

GUIDELINES FOR SUBMITTING YOUR PHOTOS

To ensure your virtual consultation is as precise and productive as possible, please follow these instructions when taking your photos. These images allow us to assess your facial anatomy clearly and design the best treatment plan for you.

Photo Quality: Send HIGH resolution only (largest file size).
Image Framing:
- Have someone else take the photos at 6 feet away and zoomed in, rather than selfies to avoid a “fish eye” distortion of your features.
- Be sure your entire face is visible and in focus.
- Avoid close-up shots or using filters.
- Keep the camera lens at eye level.
Lighting: Use indoor lighting and face the light source. Avoid flash photography or standing in front of windows, which can cause shadows or backlighting.
Keep hair back with a ponytailer or hair band.
Facial Expression: Keep a relaxed, neutral expression— one not smiling and one smiling
Background: Stand against a plain, solid-colored wall without patterns or clutter.
Angles: with your hair pulled back so your jawline, neck, and ears are clearly visible, take...
- ONE frontal photo, facing the camera directly, with your head level (not tilted up or down).
- TWO profile photos from each side.
- TWO angled photos at a diagonal.
- ONE slightly downward angle photo from both sides—gently tuck your chin and look downward at 45-60 degrees
- ONE photo if you're interested in rhinoplasty, with your head tilted back so we can see the base of your nose and nostrils.

Front view **

Drop files here or