Pre-Consultation Intake Form

Thank you for your interest in scheduling a consultation with Dr. Shaw.

In order to make sure your consultation process is both effective and efficient, please fill out the Pre-Consultation Intake form completely and as accurately as possible.

Please have a friend or partner take photographs for upload to our secure HIPAA compliant mail server.

My clinical nurses and I will review your information to make sure we don’t need any additional information or medical clearances to help us provide the most successful outcome possible.

If you’ve had previous cosmetic surgery of the procedure of interest,  please bring prior operative reports, photos and implant information (if applicable) to your consultation appointment.

If this consultation involves a revision of a procedure performed by another surgeon, please wait until you are at least 9 months post-op to schedule your consult.

Thank you and I look forward to speaking with you!

Dr. Shaw performs the following procedures:
  • Face Lift (Rhtidectomy)
  • Autologous Fat Transfer to Face
  • Eyelid Lift (Blepharoplasty)
  • Brow Lift
  • Rhinoplasty – Open / Closed
  • Ear Pinning (Otoplasty)
  • Breast Augmentation
  • Breast Lift (Mastopexy)
  • Breast Reduction  (BMI <30)
  • Breast Implant Exchange / Revision
  • Abdominoplasty (BMI <30)
  • Labiaplasty
Tell Me About Yourself
Dr. Shaw Does Not Perform the following procedures:
  • Large Volume Liposuction
  • Circumferential 360-degree Body Lifts
  • Brachioplasty (Arm Lift)
  • Thigh Lift
  • Brazilian Butt Lift
  • Fat Transfer to the Buttocks or Breast












Please Answer These Questions If You Are Planning
To Have Any Type Of Breast Surgery





Upload Your Pictures
If you have some photos of yourself that you would like to share, please use the upload button
below to send them to us. For best results: Use a solid background.
Take one frontal photo with your body or face centered and facing forward.
Take one or two side views with your body or face centered and facing to the right and/or left.