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Virtual Consultation – Body Procedures

1 Contact Information

2 Detailed Information

3 Upload Photos

First Name*
Last Name*
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Age*
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Reason for your Consultation (List All)*
Medical history information the doctor should be aware of?

Photos of the areas you are wishing to improve are required before recommendations can be made. Scroll down to see photo instructions below.

We respect your privacy. Your images, by law, will be kept on a highly secure server. However, if you’re a bit wary of sending pictures, please call to speak with one of our Nurses or Aesthetic Consultants (not a salesperson). We’re sure you will feel more comfortable after a brief conversation.
Max of 6MB per image. 4 images max. JPG, JPEG, GIF, or PNG.
Drop files here or
Accepted file types: jpg, gif, png, jpeg.
Who referred you to us or how did you hear about us?
Please tell us any other relevant information that will help our team to develop the best treatment plan for you.
Photo Instructions
1. Please take Photos in front of a plain background. For example, use a plain-colored wall or plain-colored sheet (white is preferable) hung on a wall.
2. Photos should be taken from just below your chin to your feet. The whole torso area should be visible with no undergarments obscuring the area to be examined. Hands and arms should not be raised as this lifts the abdomen to an unnatural position. Do not "suck in" the abdomen as this also creates an unnatural position. Inhale and exhale out to completely relax your abdomen. Hands can rest on your hips with elbows bent naturally to the sides. Be as relaxed as possible for the best photo outcome.
3. Keep the camera angle straight forward. Do not angle down or up as this will also create an unnatural position/view of the abdomen area.
4. You will need to take your photos without any garments on; for example, no shirts covering the abdomen area.
5. A total of 4 images/views are needed: 1 front view, 2 side views, and 1 full back shot.
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* DISCLAIMER: Individual results vary. Patient testimonials, images or videos do not constitute a promise or representation of any particular outcome or experience. Each patient’s experience, recovery and results will be unique depending on their skin, age, health and other individual factors. Best results may be promoted with a proper diet and regular exercise. Users should review the "terms of use" before using the Web site. This web site is for information only. Do not use the information herein to diagnose or treat your cosmetic surgery or medical problems. You should contact your physician with all medical questions and concerns before using the Web site. Serving the tri-state area, including New York, NY (NYC), New Jersey (NJ), Pennsylvania (PA) © by Pocono Medical Care, Inc. and Richard E. Buckley, MD. All rights reserved.
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Virtual Consultation – Body Procedures

MilfordMD Cometic Dermatology Surgery & Laser Center