Tattoo Removal

View Case

First Name*
Last Name*
Phone*
Email*

Please list us as a safe sender. If you do not see a response within 48-hours please check your spam filter.
Procedure of Interest*
Virtual Consultation*
Message*
HIPAA Disclaimer
“This e-mail message and any documents attached to it are confidential and may contain information that is protected from disclosure by various federal and state laws, including the HIPAA privacy rule (45 C.F.R., Part 164). This information is intended to be used solely by the entity or individual to whom this message is addressed. If you are not the intended recipient, be advised that any use, dissemination, forwarding, printing, or copying of this message without the sender's written permission is strictly prohibited and may be unlawful. Accordingly, if you have received this message in error, please notify the sender immediately by return e-mail or call (860) 409-1515, and then delete this message. Please be advised that communications via email over the internet are not secure. Although it is unlikely, there is a possibility that information you include in an email can be intercepted and read by other parties besides the person to whom it is addressed. If you prefer to exchange information in a more secure format, we suggest doing so by telephone”.
Name
This field is for validation purposes and should be left unchanged.

HIPAA Disclaimer