Get Started.

Complete the form to schedule your consultation.

Please allow 48 hours for an emailed response.

Looking forward to meeting you.

Contact Us.

[email] bakera@associnps.com
[phone] (757)491-3535

[fax] (757)422-4750

Associates In Plastic Surgery

1037 First Colonial Rd.
Virginia Beach, VA 23454

Name

First Name

Last Name

Email

Phone

(###)

###

####

How did you hear about Dr. Denk?

What procedure are you interested in?

When are you planning to have surgery?

This may include 1-2 weeks off work for recovery.

Age

Height

Weight

BMI OF 30 OR LESS IS REQUIRED FOR A CONSULTATION

Do you have any health conditions or issues? (i.e.: high blood pressure, anemia, diabetes)

Please also list current medications.

How many days/week do you exercise?

Do you smoke/vape nicotine?

Yes

No

Have you had previous surgeries?

Yes

No

If so, what and when?

Do you have children?

Yes

No

If so, how many and how old is the youngest?

Please include front, side, and back view photos with all Abdominoplasty, Liposuction, BBL and Body Contouring submissions.

FileField; MaxSize=2000000 kb; Multiple; addText=Upload_Photos;

Your information is used in accordance to our Privacy Policy.