Internet Consultation

1. Completely fill out and submit the Internet Consultation Form to the left.

2. Get the 5 necessary photos taken. It is imperative that you use a zoom lens with adequate lighting and a solid color background for these shots. Any camera with a zoom lens at full magnification should be sufficient for these pictures. A normal point and shoot wide–angle lens will distort the face and nose too much for an accurate evaluation. Use a solid background with good lighting and no shadows. Any portrait studio (Olan Mills, K-Mart, etc.) should be able to provide these shots easily and at a low cost. Photos can be emailed to drhamra@drhamra.com or submitted online via our Online Photo Submission Tool.

3. The 5 photos needed are: 1 Lateral (side view), 2 oblique (3/4 view), 1 frontal and 1 close up of the eye. Make sure the pictures are head shots and not full body. Ears should be visible and hair pulled back and off of forehead.

4. Our office will contact you via email with the results of your screening consultation.

Print instructions to take to the photographer.

Online Photo Submission

Sam T. Hamra, M.D.
9301 N. Central Expressway
Dallas Texas 75204
Phone: (866) 773-9181
Fax: (214)754-9080

Click here for a map and driving directions

Our practice offers patients the option of submitting information and photos through this website, rather than visiting our office for a consultation. If you would like to undergo facelift surgery with Dr. Hamra, please carefully fill out and submit the form below along with the required photos. Thank you.

1. INTERNET CONSULTATION FORM

Please Answer All Questions

*Patient Name:
*Mailing Address:
*City, State, Zip:
Phone Number:
Date of Birth:
*Email address:
What type of surgery are you considering:
*If you are considering a revision facelift, when was your previous surgery performed?
(mm-yyyy)

Who did your surgery? (Optional)

Personal History

*Is your general health good?	Yes	No
*Do you smoke?	Yes	No

*Date of last physical examination:
(mm-dd-yyyy)

Medications: Are you now or have you ever taken any medications on a regular basis (aspirin, birth control pills, vitamins included)? Please list:

Questions and Concerns

Please double check that All Questions have been answered before submitting this form. Thank you.

2. SUBMIT YOUR PHOTOS ONLINE

Photos can be emailed to drhamra@drhamra.com or submitted via our Online Photo Submission Tool. Please read the requirements, on the right side of this page, before submitting your photos online. Thank you.

Primary Facelift & Facelift Correction - Dallas