Verify Your Surgeon Will Be Doing the Surgery – DESCHAMPS BRALY CLINIC

First Name*
Last Name*
Phone*
Email*
Procedure of Interest*
Message
insurance acknowledge*
- I acknowledge & understand that the Deschamps-Braly Clinic does not accept insurance as payment.
consultation acknowledge*
- I acknowledge & understand that there will be a non-refundable consultation fee charged prior to meeting with the team.