Cosmetic Surgery Miami, Plastic Surgeon Florida, Cosmetic Surgeon Miami

Appointment Request

The Selem Center
814 Ponce de Leon Blvd., Suite 510
Coral Gables, FL 33134
305-444-0221

First Name *
Last Name *
Address *
City *
State
Zip Code
Country
Country Code
Phone *
Email *
Appointment Date
Appointment Time
Reason for Appointment *
To validate this form, please type the Security Word from the image into the text box below.
Your Security Word
Enter Security Word *
If you have any further question, please do not hesistate to contact us
*Cancellation Policy:* The patient has 24 hours prior to the appointment to cancel or change the appointment. In the event that patient does miss the appointment, we reserve the right to charge the patient for the consultation.The 24 hour cancellation policy is a courtesy to the docttors at The Selem Center and their time.
* are required fields.