The Refine Institute offers online consultations so you may start the conversation with Dr. Pratt before you ever leave home. Below, you can share your information and desires through e-mail or you may also print and mail these forms to our office.
Personal Information
*First Name
*Email Address
*Street Address 1
 
*How did you hear about us?
 
*Last Name
*Phone (xxx-xxx-xxxx)
Address 2
 
*City
*State
*ZIP
 
Birth Date (mm/dd/yyyy)
 
Gender
M   F
 
Height (ft/in)
 
Weight (lbs.)
 
Areas of Interest
Body Contouring
  • LipoSculpture
  • SmartLipo
  • Mini Tuck & Tummy Tuck
  • Natural Buttock Augmentation
 
Facial Sculpting
  • Eye Procedures
  • Natural Facial Sculpting
  • SmartXide DOT Laser
  • Non-Surgical Facelift
  • Nutrition Skin Therapy
  • Botox, Juvaderm, Restylane
 
Breast Aesthetics
  • Breast Augmentation
  • Breast Lift
  • Minimally Invasive Reduction
  • Breast Reduction
  • Male Breast Reduction
 
Your Photos
Other Information
When are you interested in having a procedure done?
Have you had any prior body contouring, facial or breast procedures in the past? If so, please explain.
Do you have any further questions or concerns regarding surgery and procedures? If so, please specify.
Yes, please sign me up for your quarterly newsletter and send me ongoing seminar information.

Online Consultation

Online consultation with Dr. Pratt for Liposuction patients in Charlotte, NC
Click here

 

Dr. Pratt

Specializes in Liposuction, SmartLipo, Breast and Body procedures