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Vampire ® PRP Consultation Online

The Vampire® PRP Consultation Online is a simple questionnaire that is submitted to our Doctors to see if Face Doctors has a solution that is right for you. It is obligation free and absolutely confidential.

Our Doctors will respond within 24 hours to your submission from your given email address. For a comprehensive consultation please contact Face Doctors to make an appointment.

* Indicates required field

How did you hear about this site? *

Internet Search Advertisement Friend Other

Face Doctors Website. Vampire® Consultation Online *

Yes

If Other please specify: *

Name *

First

Last

Age *

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

What Vampire Treatments are you interested in? *

Vampire Breast Lift® Vampire Facial® Vampire Face Lift® Vampire Hair Growth® Vampire Scar Removal® O Shot® Treatment Other

Please explain in further detail what your concerns are, and what you want to achieve *

Past Medical and Surgical History *

Active Skin Infections Acne Scarring Burns, Surgical and Traumatic Scarring Keloid Scarring Heart Disease Hypertension Diabetes Liver or Kidney Disease Acute or Chronic Infections Autoimmune Disorders Immunosuppression Blood Disorders Platelet Disorders ITP PDS Blood Thinning Medications Steroid Therapy Skin Cancer Melanoma SCC BCC Other Cancers Breast Augmentation Cosmetic Surgery Genitourinary Disease Gynaecological Surgery Hair Transplant Other NO MEDICAL PROBLEMS

If yes please explain. *

Current Medications. If none please write NIL. *

Have you taken any of the following in the last 2 weeks *

Aspirin Anti-inflammatories Voltaren-Diclofenac Nurofen or Naproxen Fish Oils or Omega 3s None of the above

If yes, when were they taken? *

Smoker. Note smoking has an adverse affect on all Vampire® Treatments. *

Yes No

If yes, how many per day or week? *

Allergies. If none please write NIL. *

Book an appointment. *

Yes, please call me. Yes, please email me. I would like more information.

Newsletter sign up *

By submitting this form you will be signed up to the Face Doctors Clinic Newsletter. We respect your privacy and you can unsubscribe at anytime.

Submit

Your personal details will remain confidential and not be disclosed to any third parties. You have the right to view, change or delete this information on request. This questionnaire is not comprehensive, and does not replace a full history, and physical examination and further information may be necessary on follow up. Due diligence will be exercised for making a thorough assessment.

Book For Auckland Clinics

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Auckland Choose Location *

Remuera Howick Manukau Head Office (No Clinic)

Ideal date and time *

Treatments Required *

Or email [email protected]

Submit

Book For Northland Clinics

* Indicates required field

Name *

First

Last

Email *

Phone Number *

NORTHLAND CHOOSE LOCATION *

Warkworth Marsden Cove Whangarei Kerikeri Doubtless Bay

IDEAL DATE AND TIME *

TREATMENTS REQUIRED *

Or email [email protected]

Submit

Please note this does not confirm your booking. We will get in touch with you to confirm your appointment time.
By submitting this form you will be signed up to the Face Doctors Clinic Newsletter. We respect your privacy and you can unsubscribe at anytime.
Please note we have allocated client parking, all unauthorized vehicles may be clamped or towed at owners expense. Clamping proceeds will be donated to monthly charity of our choice.

Face Doctors. Sign up to our Education & New Treatment Protocol Newsletter

* Indicates required field

Name *

First

Last

Email *

Subscribe To Newsletter

Website by Face Doctors 2024

Vampire ® PRP Consultation Online

Book For Auckland Clinics​

Book For Northland Clinics

Face Doctors. Sign up to our Education & New Treatment Protocol Newsletter​

Book For Auckland Clinics

Face Doctors. Sign up to our Education & New Treatment Protocol Newsletter