Consultation Request

If you are considering cosmetic surgery we suggest a private consultation with Dr. Ala Lozinski to have your questions answered fully. To book an appt. please complete the form below.

Required fields are marked with *

Name:*
Mailing Address:*
City:*
Province:*
Postal Code:*
Home Telephone:
Business Phone:
Other Phone:
E-Mail:


Please tell us which procedure you wish to discuss during your consultation:

Tumescent Liposuction
Laser Neck Lift
Laser Wrinkle Removal
botox®: Frown Lines + Brow Lift
Chemical Peels
Collagen Restylane Artecoll		 IPL Photorejuvenation
Laser Treatment Facial Veins
Leg Vein Treatment
Non Sugical Rejuvenation
Thermage
Other - if other procedure(s), please specify:


Please tell us how you want us to contact you to arrange your consultation and
ensure that the appropriate phone number is provided:

Home
Work E-Mail
Other - if other contact method, please specify:


- Home - About Aestheticare - About Dr. Lozinski - Contact Us - Consultation Request - Area Accommodations - Disclaimer -



- Tumescent Liposuction - Neck Lift - T-Lift - Laser Eye Lift - Botox® - Restylane & Juvederm - IPL Photo-Rejuvenation - Vasculight - Laser Hair Removal - Laser Wrinkle Removal - Chemical Peels - Leg Vein Treatment - Thermage - Non-Surgical Rejuvenation -

This is a Canadian web site. Its content is intended for Canadian residents.
© 2007 Aestheticare.ca. All rights reserved. Aestheticare is a registered trademark of Aestheticare Ltd.