Patients Medical History

If you have already booked your date with Didi, please take a moment to fill out the form below. After you press submit your answers will be automatically delivered to Didi and to Dr. Lev. IMPORTANT: If you have not booked your date, please don't continue filling out this form. You first must be assigned a date by Didi so please email her at trlwd2@gmail.com to schedule.

MUST READ THE FOLLOWING:

PRE-OPERATIVE REQUIRED TESTS
NICOTINE USERS RISKS
POSSIBLE COMPLICATIONS

After you have read ALL of the above information, go to Dr. Lev's Pre-Op Questionnaire below.