Where do you live?
Body Mass Index
What am I interested in?
When do you expect to have this procedure?
Do you have any chronic illness?
Indicate the chronic illness
do you take any medication?
Indicate the medication
Have you had cosmetic surgery before?
Indicate the cosmetic surgery
How many pregnancies have you had?
Did you have a cesarean section?
Are you planning to have a pregnancy later?
Do you smoke?
Do you have the complete Covid vaccination system?
How would you like us to contact you?
Do you have a place to stay during your recovery period after the surgery?
Would you like information about your stay at a recovery house?
Do you have any extra comments?