預約表單-醫學美容

Full name *

Gender *malewomen

Birthdate *DD12345678910111213141516171819202122232425262728293031/MM123456789101112/YYYY1946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021

Phone number *

LINE ID

Email *

Contact method * phoneLINEemail

聯絡時段(可複選) *

• 9:00-11:00
• 12:00-13:00
• 14:00-18:00

Areas of concern (can choose more than one) *

• Spots
• Large pores
• Acne scars
• Sunken cheeks
• Face lift
• Facial restructuring
• Painless hair removal
• Brightening and moisturizing
• CoolSculpting (cryolipolysis)
• Vaginal rejuvenation
• Optical surgery
• Treatment for bags under eyes
• Rhinoplasty
• Jaw sculpting
• Breast enlargement
• Liposuction
• Other

Details

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