Primary Office
All fields are required
Type of Visit
New Cosmetic Consultation
Follow-up of Cosmetic Consultation
Follow-up of Neuromodulator Injection
New Oculoplastic
New Blepharitis
New Blind, Painful Left Eye
New Blind, Painful Right Eye
New Blowout Fracture
New Brow Ptosis
New Canalicular Stenosis
New Acute Canaliculitis
New Chronic Canaliculitis
New Chalazion
New Conjunctival Lesion
New Dacryocystitis, Bilateral Acute
New Dacryocystitis, Left Acute
New Dacryocystitis, Right Acute
New Dacryocystitis, Bilateral Chronic
New Dacryocystitis, Left Chronic
New Dacryocystitis, Right Chronic
New Dermatochalasis Consultation
New Dry Eyes
New Ectropion, Bilateral Lower
New Ectropion, Right Lower
New Ectropion, Left Lower
New Entropion, Bilateral Lower
New Entropion, Left Lower
New Entropion, Right Lower
New Entropion, Bilateral Upper
New Entropion, Left Upper
New Entropion, Right Upper
New Epiblepharon
New Exophthalmos, Bilateral
New Exophthalmos, Left
New Exophthalmos, Right
New Left Horner
New Right Horner
New Lagophthalmos
New Lid Lesion
New Lid Retraction
New MGD
New Nasolacrimal Duct Obstruction, Bilateral
New Nasolacrimal Duct Obstruction, Left
New Nasolacrimal Duct Obstruction, Right
New Orbital Fracture
New Orbital Mass
New Preseptal Cellulitis, Left
New Preseptal Cellulitis, Right
New Proptosis
New Ptosis, Bilateral
New Ptosis, Left
New Ptosis, Right
New Punctal Ectropion, Bilateral
New Punctal Ectropion, Left
New Punctal Ectropion, Right
New Punctal Stenosis, Bilateral
New Punctal Stenosis, Left
New Punctal Stenosis, Right
New Tearing
New Thyroid
New Blepharospasm
New Blurry Vision
New Cranial Nerve IV
New Cranial Nerve VI
New Diplopia
New Hemifacial Spasm
New Left HH VF Defect
New Right HH VF Defect
New Optic Atrophy, Bilateral
New Optic Atrophy, Left
New Optic Atrophy, Right
New Optic Nerve Drusen, Bilateral
New Optic Drusen, Left
New Optic Nerve Edema, Bilateral
New Optic Nerve Edema, Left
New Optic Nerve Edema, Right
New Optic Neuritis, Bilateral
New Optic Neuritis, Left
New Optic Neuritis, Right
New Optic Neuropathy, Bilateral
New Optic Neuropathy, Left
New Optic Neuropathy, Right
New Pseudotumor Cerebri
New Visual Field Defect
Procedure: dermal filler injection
Kybella
Kybella Touch Up
Post Accutite
Post Facetite
Office
Primary Office
Reason for Visit
e.g. Initial Consultation
Patient name
Firstname Lastname
Date of birth
mm/dd/yyyy
Email
email@example.com
Home phone
(555) 555-5555
Cell phone
(555) 555-5555
Requested time
Select a time below under Available Times
Office Address:
20398 Blauer Drive Saratoga CA 95070
20398 Blauer Drive Saratoga CA 95070
New and Existing patients can make appointments online.
Office Phone:
+1 408-502-5000
You must select a date and time for your appointment.
Available Times
Previous Week
Next Week
Visit Length:
60 minutes
Submit Appointment Request
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