Fast Quotes for English Speaking Patients – Quotes from Dr. Héctor García

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Email*

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What country are you coming from?*

City*

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Age*

Height*

Weight*

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BMI Calculator Test 1*

IMPORTANT:

You will be unable to submit a quote based on this information.

You currently have a Body Mass Index (BMI) score that is over our maximum allowed to insure your procedure. Please speak to a licensed professional (nutritionist or trainer) to assist with safely reducing your BMI before submitting for a quote.

Do you suffer from ANY of the following illness(es)?*

*Check all that apply. Please answer truthfully. Incorrect or answers that are intentionally wrong will disqualify you from surgery.

None of These

History of Deep Vein Thrombosis (DVT)

Hyperthyroidism

Graves Disease

Uncontrolled Hypothyroidism

Cancer

Diabetes

High Blood Pressure

Respiratory Disease

Heart Murmur

Sickle Cell Anemia

Thalassemia

Anemia

Rheumatic Disease

Lupus

Arthritis

Sjogren's Syndrome

Bariatric Surgery

IMPORTANT:

You will be unable to submit a quote based on this information.

You currently have a condition that disqualifies you from being pre-approved for surgery. This strict protocol is for your safety and due to our insurance carriers inability to cover or provide policies to patients with these illnesses or conditions.

Have you had any children?*

Have you had any previous aesthetic surgeries?*

Yes

Please list them here?*

Desired Procedure(s)*

*Check all procedures that apply

Ab-Etching

Abdominoplasty-Tummy Tuck

Brazilian Butt Lift

Breast Implant Exchange

Breast Implants

Breast Lift with Implants

Buccal Fat Removal

Chin Lipo

Hair Transplant

J Plasma / Retraction

Labioplasty

Liposuction

Male Breast Reduction

Male Tummy Tuck

Instructions for uploading photos:
- Don't upload photos larger than 1.5 MB, it will take time or not upload.
- Take 4 photos with the front camera, especially with the latest technology devices.
- Have a stable wi-fi connection to upload your photos - Upload your photos one by one (don't upload all 4 photos at the same time).
- If your photos exceed the weight mentioned above, please reduce the weight optimizing the images in the following link Link.

Photo guide for how to take your photos

Photos - Front / Back / Left Profile / Right Profile*

Front View

Back View

Left Profile

Right Profile

*For a faster quote, please upload your high quality photo(s) without face showing unless you are quoting for facial procedures.

Do you have history of problems with the veins in your legs or have you been diagnosed with deep vein thrombosis?*

Yes

Do you have history of Major Weight Loss?*

Yes

Do you have Medication Allergies*

Yes

Please list your medication allergies here

Are you currently taking any Birth Control, Vitamins, Supplements or Medication?*

Yes

Please list the names of the medications, vitamins or supplements here

Final Details

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Fast Quotes - English

Details needed for your quote

Photo guide for how to take your photos

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