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For Appointments :	(02) 99061555
	1300 556 615

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Online Consultation - Liposculpture

Find out an accurate costing of a procedure conveniently and quickly. TO QUALIFY FOR THE 10% REDUCTION IN THE LIPOSCULPTURE PROCEDURE FEE, YOU MUST PRINT OUT THE REPLY THAT YOU RECEIVE FROM THE CLINIC AND BRING IT WITH YOU AT THE TIME OF CONSULTATION.
Ask any specific questions that you may have about cosmetic surgery.
As part of the consultation process, please feel free to send a separate email ( to Consult at Alia Clinic ) with one or two photos as attachments. Many people now do this and it does help give a more accurate reply.

Use this form to help you get the most out of your consultation. Please fill in the fields below.

Alternatively, you may submit the information directly to the clinic by simply printing the form and faxing it to (02)99061900.

* essential

Personal Details
Name	*
Age	*
Sex	*
Address for Correspondence
Email Address	* Please enter this carefully to ensure an accurately addressed reply.
Phone Number


Height (cms)
Weight (kg)	* Essential for liposculpture - optional for others

Liposculpture Body Areas
Please list below areas of your body that you think could be improved by liposculpture. (e.g hips, abdomen, flanks, inner thighs)	*
Please enter any questions or comments.
Please give me information on the approximate costing of the procedure.

Optional photos - Please browse and add your relevant photos (jpg or jpeg files).If do you add photos, it will take longer to send this form. After you have added your photos, press the "Submit Enquiry" button, then wait for our reply page to ensure your form details and photos have been sent.
Photo attachment 1	(maximum size 100KB per image)
Photo attachment 2	(maximum size 100KB per image)

If you have any problems in the transmission of this form, please forward a separate email to aliaclinic@gmail.com

For more information about choosing a doctor or deciding on a cosmetic procedure, please download a copy of the Australasian College of Cosmetic Surgery’s patient information brochure, "Things you should know". A copy of the ACCS Code of practice is also available by visiting the College’s website.