CONTACT
WELCOME TO ODC
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Welcome to ODC
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Our Skin Specialists
Our Administration
Our Products
Our Doctors
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Dr. Jennifer MacIsaac
Dr. James P. Bonaparte
Dr. Peter Brownrigg
Dr. Mark Kirchhof
Dr. Sachin A. Chitte
Dr. Kristy Staples
Dr. Shady Piedra
Dr. Bernie Lalonde
Dr. Mariko Hashimoto
COSMETIC SERVICES
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Cosmetic Dermatology
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Botox (Neuromodulators)
Dermal Fillers
Preventative Aging
Skin Resurfacing
Skin Rejuvenation
Non-Surgical Body Contouring
Mole Removal
Laser Hair Removal
Tattoo Removal
Excessive Sweating (Hyperhidrosis)
Vaginal Rejuvenation
COSMETIC CONDITIONS
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Cosmetic Conditions
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Melasma
Hyperpigmentation
Redness
Sun Damage
Rosacea
Acne
Refining Pores
Unwanted Lesions
Cyst Excision (Removal)
Moles
Vaginal Incontinence
COSMETIC TREATMENTS
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Cosmetic Treatments
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Botox (Neuromodulator)
Dermal Filler
Clear and Brilliant
Coolsculpting
Secret RF
PicoWay
Opus Plasma
CO2 Skin Resurfacing
BBL/IPL
MOXI
Halo
Ultherapy
GentleMax Pro Laser Hair Removal
VBEAM
Thermage
Cryotherapy
Sclerotherapy
COSMETIC SURGERY
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Cosmetic Surgery
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Tummy Tuck
Blepharoplasty Surgery
Cyst Excision (Removal)
Brachioplasty
Breast Augmentation
Buccal Fat Pad Excision
Facelift
Neck Lift
Labiaplasty
Liposuction
Otoplasty
Rhinoplasty Surgery
Thigh Lift
SKINCARE & ONLINE STORE
RESOURCES AND FAQS
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Resources
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Medical Surgery
Before and Afters
Patient Reviews
Healthcare Providers
Press Release
Frequently Asked Questions (FAQ)
▼
Skin Health FAQs
Surgical FAQ
CONTACT US
Schedule consultation
CONTACT
WELCOME TO ODC
Welcome to ODC
Our Skin Specialists
Our Administration
Our Products
Our Doctors
Dr. Jennifer MacIsaac
Dr. James P. Bonaparte
Dr. Peter Brownrigg
Dr. Mark Kirchhof
Dr. Sachin A. Chitte
Dr. Kristy Staples
Dr. Shady Piedra
Dr. Bernie Lalonde
Dr. Mariko Hashimoto
COSMETIC SERVICES
Cosmetic Dermatology
View All
Botox (Neuromodulators)
Dermal Fillers
Preventative Aging
Skin Resurfacing
Skin Rejuvenation
Non-Surgical Body Contouring
Mole Removal
Laser Hair Removal
Tattoo Removal
Excessive Sweating (Hyperhidrosis)
Vaginal Rejuvenation
COSMETIC CONDITIONS
Cosmetic Conditions
View All
Melasma
Hyperpigmentation
Redness
Sun Damage
Rosacea
Acne
Refining Pores
Unwanted Lesions
Cyst Excision (Removal)
Moles
Vaginal Incontinence
COSMETIC TREATMENTS
Cosmetic Treatments
View All
Botox (Neuromodulator)
Dermal Filler
Clear and Brilliant
Coolsculpting
Secret RF
PicoWay
Opus Plasma
CO2 Skin Resurfacing
BBL/IPL
MOXI
Halo
Ultherapy
GentleMax Pro Laser Hair Removal
VBEAM
Thermage
Cryotherapy
Sclerotherapy
COSMETIC SURGERY
Cosmetic Surgery
View All
Tummy Tuck
Blepharoplasty Surgery
Cyst Excision (Removal)
Brachioplasty
Breast Augmentation
Buccal Fat Pad Excision
Facelift
Neck Lift
Labiaplasty
Liposuction
Otoplasty
Rhinoplasty Surgery
Thigh Lift
SKINCARE & ONLINE STORE
RESOURCES AND FAQS
Resources
Medical Surgery
Before and Afters
Patient Reviews
Healthcare Providers
Press Release
Frequently Asked Questions (FAQ)
Skin Health FAQs
Surgical FAQ
CONTACT US
AESTHETIC INTEREST QUESTIONNAIRE
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AESTHETIC INTEREST QUESTIONNAIRE
Sex
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Female
Male
What is your main area of concern?
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I would like to be advised on
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How I can look better for my age
How I can change something that has been bothering me for years
How I can look more attractive
Other
Have you had a consultation or treatment for a cosmetic procedure before?
*
Yes
No
How often do you think about wanting a cosmetic procedure?
*
Most days
Weekly
Monthly
Which three statements best reflect how you would like to look and feel after the treatment?
*
I want to look less tired
I want to look less angry
I want to look less sad
I want a less saggy appearance
I want to look more youthful
I want to look more attractive
I want my face to look slimmer
I want softer features
How would you rate the quality of your skin?
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Please select
Poor
Fair
Good
Very Good
Excellent
If you could enhance an aspect of your skin, what would you enhance?
*
Hydration
Elasticity
Smoothness
Colour
These treatments/products interest me
*
Skin Enhancement
Skin injectables
Skin products
Laser treatment
Peeling
Microdermabrasion
Facial
Skin tightening
Facial Improvement
Facial fillers
Wrinkle relaxers
Face lifting
Ear correction
Fat reduction - chin
Nose surgery
Eyelid correction
Brow correction
Body Contouring
Fat reduction
Breast enlargement
Breast correction
Tummy tuck
Arm lift
Buttock augmentation
Other
Laser hair removal
Hair replacement
Waxing
Labiaplasty
Scar revision
How did you hear about us?
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My doctor
Advertisements/periodicals
A friend or family member
Website
Search engine
Social media platform
Seminar
Personal Details
Full Name
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Email Address
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Phone
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First Name
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Last Name
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Email
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Type of Consultation
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Type of consultation
In person consultation
Virtual consultation
Treatments Available
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Cosmetic Treatments
Cosmetic Surgeries
Procedure of Interest
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Select Type of Treatment
Body contouring
Botox
Enhancing and defining lips
Filler treatment
Laser hair removal
Latisse
Maintaining a youthful appearance
Reducing fine lines and wrinkles
Reducing pores
Removing age spots, moles, skin tags
Skin care
Skin rejuvenation
Skin resurfacing
Skin tightening
Treatment of red or brown tones
Treatment of scars
Tattoo removal
Procedure of Interest
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Select Type of Treatment
Abdominoplasty
Blepharoplasty
Body contouring
Brachioplasty
Breast augmentation
Breast lift
Buccal fat pad excision
Chin Implant
Chin Liposuction
Cyst excision
Earlobe repair
Face / Neck lift
Labiaplasty
Liposuction
Liquid rhinoplasty
Neck Liposuction
Otoplasty
Rhinoplasty
Thigh lift
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