We are happy to assist you as you explore your self-improvement options.
Call us toll free at 800-769-0849

If you would you like to receive our complimentary patient information packet, or schedule a complimentary consultation with one of our board certified plastic surgeons, simply use the form below to contact us. If you prefer to request information or schedule a consultation by phone, please call us at 800-769-0849.

For your privacy, this information will be used solely by the Clinic of Cosmetic Surgery and will not be shared with any other persons or organizations.
 
First Name:
Last Name:
Street:
City:
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Postal Code:
Phone:
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Where did you first hear about Clinic of Cosmetic Surgery?
Which procedures or services are you interested in?
Other or additional procedures
Date of Birth
What is the preferred way for us to contact you Monday-Friday to confirm your appointment?
Preferred day of the week for appointent?
Time frame for surgery?
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Physician requested:
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5201 North Port Washington Rd. Milwaukee, WI 53217 - ph 414.963.0500 - fx 414.963.0359 - 800.769.0849 - Contact Us