Skip to main content

menu

You can use this form to request a pre-operative consultation with physicians at the Flaum Eye Aesthetics Center only. Please be aware that elective aesthetic procedures are not covered by traditional insurance. There is a $100 consultation fee due at your initial visit. This fee can be applied to the cost of any elective aesthetic fee performed by Dr. Gonzalez.

Request A Non-Urgent Appointment

For questions about your appointment, please contact us at (585) 275-7080. Use this form to request a non-urgent appointment only. All requests will be processed within 24 hours during regular business hours, Monday - Friday, 8:00 am-4:30 pm.

place field "FirstName" below
Name
place field "LastName" below
place field "Street" below
Address
place field "City" below
place field "State" below
place field "Zip" below
place field "HomePhone" below
Contact Information
place field "WorkPhone" below
place field "Email" below
place field "ContactPref" below
place field "Interest" below
place field "DayFirst" below
Scheduling Preferences

Please indicate your first choice for day and time.

place field "TimeFirst" below
place field "DaySecond" below

Please indicate your second choice for day and time.

place field "TimeSecond" below
place field "PromoCode" below
Additional Information
place field "Source" below
Our Privacy Policy