Print and complete this form to bring with you to your first appointment.
How Did You Hear About Us?*FunAsiA RadioBillboardNewspaperTVOnline AdvertisementInternet SearchFriend or FamilyOther
Preferred Service*Bioidentical Hormone Replacement TherapyTestosterone TherapySterile Implantable PelletsRejuvenating Peptide TherapyErectile DysfunctionBotoxDysportBellafillJuvedermRestylaneCoolsculptingVelaShape Body ContouringKybella Chin Fat TreatmentFat Burner ShotsPrescription Weight LossNUYU Teeth WhiteningAcupunctureChemical PeelAcne ScarsAcne TreatmentEclipse MicropenIPL Photo FacialLaser Hair RemovalViora ReactionBody Composition Analysis
Choose Preferred Location: AllenDallasPlanoSouthlake
*required
A Total Med Solutions representative will contact you within 1 business day to arrange the perfect time for your appointment, or you are welcome to call during regular business hours and schedule your appointment today.
