Welcoming Dr. Fred Weksberg and Team!

During your consultation with Dr. Weksberg's highly trained staff you will receive information on which treatments will be best suited for your individual needs. If you wish to proceed with the recommended treatment we will book your consultation with Dr. Fred Weksberg himself. The consult fee with Dr. Weksberg is $100 plus HST but that will be applied against any future treatment you might decide to undergo.

Name:		Email
Tel

What type of treatment are you interested in receiving?

	Botox		Chemical Peels
	Fillers		Silk Peels
	Thermage		Photorejuvenation (IPL)
	Fraxel		Laser Hair Removal

Do you currently see a cosmetic specialist? Yes No

Do you use physician grade skin care products? Yes No

Any other comments, questions, or requests?

We look forward to helping you soon.

Fax: 905.417.7088
9200 Weston Road Unit #26 (Located in the Shoppers Drug Mart/Tim Horton’s Plaza
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Vaughan Medical Centre 2009-2010