First Name:*Last Name:*Email Address:* Email Promotions:YesNoBy selecting "Yes", I authorize South Florida Center For Cosmetic Surgery to send me email messages regarding my account, appointments, services, and promotions.Phone Number:*Text Communication:YesNoBy entering in my mobile number above, and selecting "Yes", I authorize South Florida Center For Cosmetic Surgery to send me text messages regarding my account and about their appointments, services, and promotions using an automatic telephone dialing system. I understand that I am not required to check this box as a condition of purchasing any property, good, or service. (If I receive a text message, I can reply HELP for help or reply STOP to withdraw consent. Message and data rates may apply.)Desired Appointment Date: Date Format: MM slash DD slash YYYY Your Message:Terms of Use:*YesNoBy checking this box you agree to our Terms and Conditions. Fort Lauderdale 915 Middle River Dr. #213 Fort Lauderdale, FL33304 Phone: (800) 274-LIPO or +1(954) 565-7575 Fax: 954 565 4162 Hours & Directions »
