PDO Consultation Request Form

CONTACT INFORMATION

Name

First Name

Last Name

Phone

Preferred Contact Method

Text

Call

YOUR GOALS

What are you hoping to improve? (Select all that apply)

Sagging cheeks

Jowls / jawline definition

Nasolabial folds (smile lines)

Marionette lines

Tired / heavy appearance

Skin laxity

I want a facelift-level result

SELF-ASSESSMENT

Which best describes your face right now?

I feel like my face has dropped over time

I have fullness/heaviness in my lower face

My jawline is less defined than before

My face feels thin or hollow

I have a lot of loose skin

EXPECTATION ALIGNMENT

What type of result are you looking for?

Subtle, natural lift

Noticeable refresh

Significant change (like surgery)

TREATMENT HISTORY

Have you had dermal filler before?

Yes

Have you had PDO threads before?

Yes

Have you had facial surgery before?

Yes

PHOTO SUBMISSION (MANDATORY)

Instructions:

To properly evaluate if you are a candidate, we require clear photos of your face.

Please upload the following:

Front view (neutral expression)
Left side profile
Right side profile
Optional: smiling photo

⸻

📸 PHOTO GUIDELINES

For best results:

Natural lighting (no shadows)
Hair pulled back
Minimal or no makeup
Camera at eye level
Relaxed face (no smiling in main photo)

🔒 PRIVACY NOTE

Your photos are confidential and used only for clinical evaluation.

Facial Assessment Photos (Required)

Maximum file size: 268.44MB

TIMELINE

If you are a candidate, when are you looking to move forward?

ASAP (2–4 weeks)

1–3 months

Just researching

INVESTMENT ALIGNMENT

Threadlifting is a customized, premium treatment. Pricing varies depending on your anatomy and treatment plan.

Which best describes you?

I’m ready to invest if I’m a good candidate

I’d like more information first

I am mainly price shopping

Acknowledgment for Next Step

I understand that I must book my own appointment following the submission of this form on the AI Wellness treatment booking page here

If you are human, leave this field blank.