Virtual Consultation

WHY A VIRTUAL CONSULTATION?

Save Time

See a doctor on your schedule. No need to drive to the office for your appointment and no waiting rooms.

Privacy & Convenience

Talk with Dr. Colony from your own home with a private, HIPPA compliant connection.

Reduce Exposure

Eliminate the possibility of exposing yourself to germs by staying home for your free cosmetic consultation.

HOW IT WORKS

Our practice is now conveniently offering Virtual Consultations for our patients.

Please fill out the HIPAA compliant form below with as much detail as possible.

After reviewing your form, our office staff will reach out to you to schedule an online consultation. If you have any questions, please feel free to contact us via phone at 517.333.4960.

Your Name*
First Last
Contact Phone*
Email*
Country*
City*
Date of Birth*
Date Format: MM slash DD slash YYYY
Height(Inches)*
Weight(lbs)*
Do you smoke?*
Do you drink alcohol?*
Do you have children?*
Procedure of Interest*
Desired Surgery Date*
Date Format: MM slash DD slash YYYY
Previous Surgeries*
Current Medications*
Herbal Supplements or Vitamins*
Known Allergies*
Medical Condition*
*
- I agree to the Term & Conditions

Michigan Plastic Surgery