Online Consultation Form for Dr. Paul Chasan

Please fill out the consult form to submit information about your surgical goals and photographs of yourself for Dr. Chasan to review. By participating in an online consultation, Dr. Chasan and his staff can share preliminary information with you prior to your visit for an in-person consultation.

Please understand that an online consultation never replaces an in-person consultation, nor does it create a formal patient-physician relationship. If you have questions about arranging an online consultation, or an in-office consultation please call our office at 858.450.1555.

Online Consult Form







Select Gender:

When would you like to have this procedure?

Have you had cosmetic surgery before?
If yes, please indicate procedures:

Areas of concern?

What types of results are you looking to achieve?

How would you like us to reply?

If you have some photos of yourself that you would like to share, please use the upload tool below to upload your photos. To make the most out of your online consultation and to allow Dr. Chasan to make the most comprehensive assessment, please do your best to submit your photographs in the following format:

  1. Use a solid background.
  2. Take one frontal photo with the face or body centered and looking straight.
  3. Take at least 1, preferably 2 profile photos.

  4. Photo Upload Tool


    By checking this box you agree to the Terms of Use listed below

    Communications through our website or via email are not encrypted and are not necessarily secure. Use of the internet or email is for your convenience only, and by using them, you assume the risk of unauthorized use. By checking this box you hereby agree to hold Chasan Cosmetic Surgery, its doctors and affiliates, harmless from any hacking or any other unauthorized use of your personal information by outside parties. The opinion rendered by the physician is based on the information provided by the prospective patient and is not final. Once our office receives any patient information, it will always be maintained in the strictest of confidence.


Paul E. Chasan M.D. F.A.C.S.

1431 Camino Del Mar
Del Mar, CA 92014


Phone: 858-450-1555
Email: info@drchasan.com