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This form allows Dr. Pasquale to do a preliminary review of your case online. Please fill out the form to initiate this process.

We will review your case and contact you as soon as possible to go over your options. Thank you for contacting our practice.
 
Patient Name:
E-mail Address1:
Phone Number:
1. List in priority the things you would most like to improve about your image.
2. Have you had any previous cosmetic surgery? (If no, go to question #3)
a. What was the reason for your surgery?
b. When was your last surgery performed?
c. Who performed your surgeries? (name of doctor and specialty)
3. If you have not had another surgery, what are your realistic desires, i.e., what will/would it take for you to be satisfied with the outcome? Think about this and be honest.

 
 

Procedures

Surgical Procedures
.: Face Lift
.: Minimal-Incision
Facial Surgery
.: Weekend Face Lift
.: Facial Liposuction
.: Neck Lift
.: Brow Lift
.: Minimal-Incision
Brow Lift
.: Otoplasty
.: Eyelid Surgery
.: Asian Eyes
.: Rhinoplasty
.: Asian Noses
.: Chin & Cheek
Implants
.: Lip Augmentation
Surgery
.: Micro Hair
Transplants

Non-Surgical Procedures
 .: Feather Lift
.: Chemical Peels
.: Obagi ® “Blue” Peel
.: Dermabrasion
.: Vibraderm™
.: Injectable Fillers
.: Thermage
.: Collagen
Treatments
.: Lip Augmentation
.: Radiance ™
.: Resytlane
.: Fat Transfer
.: Botox ®
.: UltraPulse
.: Fotofacial ™
.: IPL ™ Hair Removal
.: Facial Vein
Treatment
 

Dr Michael Pasquale
677 Ala Moana Blvd.
Honolulu, HI 96813


P / 808.737.0205
F / 808.529.8631
     

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