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Call for a Consultation!

503-669-9019

Cosmetic & Reconstructive Surgery
of the Face, Body and Breast.

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Contact Us

Use the form below to receive an initial opinion from Dr. Fortes at no charge. This is for your educational purposes only, and can not be considered a true medical opinion without a proper examination in person. Dr. Fortes may be able to give you some ideas and insight on how to obtain your goals in appearance as it relates to cosmetic and plastic surgery.

Patient Name:

Email Address:

Phone Number:

1. List the things you would like to change.

2. Have you had any previous cosmetic surgery?

a. What was the reason for your surgery?

b. When was your last surgery performed?

c. Who performed your surgeries?
(Name of Doctor & Specialty)

3. If you have not had another surgery, what are your realistic
desires i.e., what will / would it take for you to be satisfied with
the outcome? Think about this and be honest.

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Willie F. Fortes - 831 Nw Council Dr Step 201 - Gresham, Oregon 97030 MAP (503) 669-9019

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