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Consultations offered at our four convenient locations in Calhoun, GA, Chattanooga, TN, Ooltewah, TN and Blueridge, GA

Patient Information Form

    YesNo
    DiabetesBlood ClotsCancerHeart DiseaseOrgan TransplantsOtherNone
    Choose For MeDr. Deal - (DRHIDEF)Dr. Kluska - (DRDADDYK)Dr. GardnerDr. SummersDr. Barker

    Please use the "choose file" buttons below to upload photos to send to us.

    • Use a solid background.
    • Take photos of the affected area from different angles.
    • Images MUST be smaller than 6mb each
    • Filetypes accepted are jpg, jpeg, png, and gif.

    Very large images may take up 5 minutes to upload. Please be patient and wait till loading has finished before navigating away from this page.

    Breast EnhancementFace & NeckBody & AbdomenBelow-The-WaistInjectablesMedSpa
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                Consultation Page Form

                  Please use the "choose file" buttons below to upload photos to send to us. We can not process a virtual consultation without images.

                  • Use a solid background
                  • Take photos of the area of interest from different angles
                  • Images MUST be smaller than 6mb each
                  • Filetypes accepted are jpg, jpeg, png, and gif
                  • Large images may take a while to upload

                  All information sent will remain private. Please allow 24 hours for us to get back to you.

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                  Contact Page Info

                    Choose For MeDr. Deal - (DRHIDEF)Dr. Kluska - (DRDADDYK)Dr. GardnerDr. Ray - (MCDREAMYHIDEF)Dr. Mason - (DRROCKINHIDEF)Carey Miller, MSN, NP-C (LIFE Wellness)Dr. SummersDr. Barker
                    YesNo
                    DiabetesBlood ClotsCancerHeart DiseaseOrgan TransplantsOtherNone
                    YesNo

                    Please use the "choose file" buttons below to upload photos to send to us.

                    • Use a solid background.
                    • Take photos of the affected area from different angles.
                    • Images MUST be smaller than 6mb each
                    • Filetypes accepted are jpg, jpeg, png, and gif.

                    Very large images may take up 5 minutes to upload. Please be patient and wait till loading has finished before navigating away from this page.

                    Breast EnhancementFace & NeckRhinoplastyBody & AbdomenBelow-The-WaistInjectablesMedSpa
                    YesNo
                    BillboardInstagramFacebookTikTokSnapchatWeb SearchOther
                    Protected by Recaptcha. Privacy & Terms