By signing below, you acknowledge that you have carefully reviewed, fully understand, and voluntarily agree to all terms and conditions outlined in the LLuxe Consultants Inc. Consulting Agreement. Your signature constitutes your acceptance of this agreement.

By signing below, I certify that the information provided in this form is accurate and complete to the best of my knowledge. I understand that withholding or providing inaccurate information may affect my treatment and surgical outcome. I consent to the collection and use of my personal and medical information for the purpose of evaluating my candidacy for the requested procedure(s).

⚠️ Important Notice

Please note that this is not a live video consultation. This is a virtual consultation in which the surgeon will carefully review the medical history, photographs, and videos you have submitted. Based on the information provided, the surgeon will evaluate your case and prepare a personalized surgical recommendation and quote.