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Name*
Phone*
Email*
Height (in.)*
Weight (lbs.)*
Procedure(s) Interested In*
Any history of blood clots, bleeding disorders, autoimmune conditions (like Lupus or Crohn's disease), diabetes, or 3 or more miscarriages?
- Yes
- No
Message
- Request A Consultation

Vennemeyer Plastic Surgery
240 Miron Dr. Southlake, TX 76092
Phone: (817) 912-1410
Serving all of Dallas, Fort Worth,
Southlake, Colleyville and Keller

Book Consultation – Tummy Tuck

Call For Consultation: 817.912.1410

We would love to hear from you! Please fill out this form and we will get in touch with you shortly.

Full name*
Phone*
Email*
Birthdate*
Date Format: MM slash DD slash YYYY
Height (ft.)*
Height (in.)*
Weight (lbs.)*
Height Total
BMI
Procedure of interest*
Using hormones/birth control/IUD?*
Nicotine within past month?*
History of blood clots, bleeding, diabetes, autoimmune conditions (lupus, Crohn’s), >2 miscarriages, or malignant hyperthermia?*
Procedure Timeframe*
Payment method*
Payment plan details*
Request Consultation*
- Virtual (most popular)
- In-person (1-hour slots, $150, open until 8pm weekdays)
Submit Picture(s)
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Allowed File Extensions: jpg, gif, png, pdf
Maximum File Size: 10MB Per Photo
Maximum Number of Files: 5

Book Consultation - Butt Lift

Call For Consultation: 817.912.1410

We would love to hear from you! Please fill out this form and we will get in touch with you shortly.

Patient Information:
Legal Full Name*
Phone Number*
Email Address*
Date of Birth*
Date Format: MM slash DD slash YYYY
Height (ft.)*
Height (in.)*
Weight (lbs.)*
Height Total
BMI
*BMI 30 or less is required for surgical safety.
Procedure(s) wanted:*
How soon do you want surgery?*
- ASAP
- Within 1 month
- Within 3 months
At my consultation this week, when I schedule my procedure I plan to pay:*
- $0 down
- $1,000 down
- More than $1,000 down
Nicotine/tobacco use:*
- Never
- Occasional
Any history of blood clots, bleeding disorders, autoimmune conditions (like Lupus or Crohn's disease), diabetes, or 3 or more miscarriages?*
- Yes
- No

Book Consultation

Call For Consultation: 817.912.1410

We would love to hear from you! Please fill out this form and we will get in touch with you shortly.

Patient Information:
Legal Full Name*
Phone Number*
Email Address*
Date of Birth*
Date Format: MM slash DD slash YYYY
Height (ft.)*
Height (in.)*
Weight (lbs.)*
Height Total
BMI
*BMI 30 or less is required for surgical safety.
Procedure(s) wanted:*
How soon do you want surgery?*
- ASAP
- Within 1 month
- Within 3 months
At my consultation this week, when I schedule my procedure I plan to pay:*
- $0 down
- $1,000 down
- More than $1,000 down
Nicotine/tobacco use:*
- Never
- Occasional
Any history of blood clots, bleeding disorders, autoimmune conditions (like Lupus or Crohn's disease), diabetes, or 3 or more miscarriages?*
- Yes
- No

Book Consultation - Breast Augmentation

Call For Consultation: 817.912.1410

We would love to hear from you! Please fill out this form and we will get in touch with you shortly.

Patient Information:
Legal Full Name*
Phone Number*
Email Address*
Date of Birth*
Date Format: MM slash DD slash YYYY
Height (ft.)*
Height (in.)*
Weight (lbs.)*
Height Total
BMI
*BMI 30 or less is required for surgical safety.
Procedure(s) wanted:*
How soon do you want surgery?*
- ASAP
- Within 1 month
- Within 3 months
At my consultation this week, when I schedule my procedure I plan to pay:*
- $0 down
- $1,000 down
- More than $1,000 down
Nicotine/tobacco use:*
- Never
- Occasional
Any history of blood clots, bleeding disorders, autoimmune conditions (like Lupus or Crohn's disease), diabetes, or 3 or more miscarriages?*
- Yes
- No