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To obtain more information about our services, or if you have any questions or comments, please complete the form below. We respect your privacy and we will not share or sell your information to anyone for any reason. The information you submit is held in the strictest confidence. Please do NOT use this form to submit protected health information; existing patients with medical concerns should call our triage line at (919) 863-0075 rather than use this form.

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I am interested in the following:
Gift Cards
Acne Treatment
BOTOX® Cosmetic Treatment
Chemical Peels
Facials
Restylane Therapy (Filler)
CosmoDerm & CosmoPlas (Filler)
Radiesse (Filler)
JUVÉDERM™ Injectable Gel (Filler)
 
Fraxel Laser Treatment
Laser Hair Removal
Laser Photorejuvenation
Microdermabrasion
Rosacea
Scar Repair & Revision
Spider Veins
Tumescent Liposuction
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4201 Lake Boone Trail, Ste. 207
Raleigh, NC 27607
919-863-0073 		Site Map | Medical Forms | Resources | Privacy Policy | Contact Us