Online Consultation Form for Dr. Paul Chasan

Please read the following information and fill out the form below.

Please fill out the consult form to submit information about your surgical goals and photographs of yourself for San Diego plastic surgeon Dr. Paul E. 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 for plastic surgery 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

Select Gender:

When would you like to have this procedure?

Have you had cosmetic surgery before?

How would you like us to reply?

Referral Source

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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.