Questionnaire before video consultation

Last name* First name Your profession

Your city Email* Phone number

Do you have any known diseases?

Do you have any drug allergies?

Do you have any known psychological problems (anxiety/depression)?

Do you smoke? If so, how much?

Are you taking medication? if so, which ones?

What I don't like with my nose:

What I want to achieve as a result:

What are my expectations for this surgery?

Have you ever had nose surgery?

Have you ever had a nose trauma?

Do you have a obstructed nose?

How much time do you spend a day thinking about your nose? <1h 1-3h >3h

How long have you been thinking about the intervention for which you came to consult?

Is there an element or opportunity that motivates you in this process?

Do you have a relative who supports you in your project?

Is there anyone in your relatives who is hostile to this approach?

What aesthetic medical or surgical intervention(s) have you ever had?

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Dr. Guillaume Carles

Surgery

Informations

Contact

Make an appointment on Doctolib

Phone: 04 11 93 27 21

You can leave a message by email at secretariatcarles@gmail.com or by Whatsapp at 06 49 67 54 35 (non-emergency calls).

The secretary can be reached on 04 11 93 27 21 Monday from 8:30 a.m. to 7 p.m., Wednesday from 3:30 p.m. to 7 p.m. and Thursday from 9 a.m. to 11:30 a.m.

For any emergency, if you cannot reach the secretary or the clinic, call 15.

Rhinoplasty

Revision rhinoplasty

Results before/after

More information

Questionnaire before video consultation

Dr. Guillaume Carles

Surgery

Informations

Contact