Luxe Medispa

Name *

Age

Suburb*

NSW - Sydney Metro NSW - Other VIC ACT WA SA QLD TAS NT International State

Telephone*

E-mail*

-----Service----- Anti-Wrinkle Dermal Fillers Laser resurfacing Vascular Lesions Endermologie Cosmedix Peels Mineral Makeup Services

-----Service----- Anti-Wrinkle Dermal Fillers Laser resurfacing Vascular Lesions Endermologie Cosmedix Peels Mineral Makeup 2nd Service

------Insurance------ Yes No Privately Insured (Health Fund):

------Enquiry------ Appointment General Enquiry Nature of Enquiry

------Select Clinic------ Darling Point (East Suburbs) Every Wednesday Baulkham Hills - Every Tuesday Clinic Interested In

Information Needed -

Kindly keep all enquiries
brief as the more complex
questions can only be
adequately answered in
a formal consultation
with Dr Tavakoli

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