L.A. Beautiful - Beverly Hills Plastic Surgery, Orthopedic Procedures, Foot and Ankle Procedures and Pain Management

We are dedicated to making your experience with us as easy and convenient as possible. If you are interested in exploring financing options, our consultants are happy to help walk you through the process so that you can secure the best rates and affordable monthly payments.

Whether you have good credit, poor credit or no credit at all, we'll do our best to get you rates and payments to fit your budget. We only do business with reputable and established financial companies and will get you a reply within 48 hours. The application process is fast and entirely confidential with minimal paperwork for you. You may apply online or complete the application when you come in for your consultation.

PRIVACY STATEMENT: All information submitted is considered strictly confidential and will never be sold, traded or given to any third party for any reason.
Information collected will be used to contact you exclusively by L.A. Beautiful.

Finance Application

Step 1 - Personal Info

First Name:

Date of Birth:

Last Name:

Gender:

Email Address:

Marital Status:

Home Phone:

() -

Age Group:

Cell Phone:

()-

Best Time To Contact You:

Work Phone:

()-

Best Number to Call:

Home Cell Work

Address

Preferred Location:

City:

Day & Time:

ZIP Code:

Years at Residence:

yearsmonths

Home Status:

Monthly Housing Cost $:

Social Security #:

- -

Procedure(s) Requested:
Arm Tuck Body Lift Botox Breast Augmentation Breast Reconstruction Breast Replacement Breast Lift Breast Reduction Brow Lift Calf Implant Cheek Implant Chin Implant Chemical Peel Cosmetic Surgery Dermabrasion Dermatology Ear Surgery Elective Surgery Eyelid Surgery Face Lift	Gastric Bypass Gortex Hair Transplant Hand Surgery Augmentation Liposuction Male Breast Reduction Medical Testing Necklift Nose Surgery Paris Lips Pectoral Implant Reconstructive surgery Scar Revision Skin Resurfacing Snoring/Breathing Spider Veins Tattoo Removal Thigh Lift Tummy Tuck Other / Not Specified

How Did You Hear About Us?
If other, please specify:
Questions / Comments:
It may take a few moments to process your form, please do not press SUBMIT more than once. Required fields have an asterisk (*) in front of them. Please complete the above form and click the "Submit" button at the bottom. As always, your contact information will be kept strictly confidential. We will attempt to reply to your inquiry within 48 hours. Assisting you in making an appointment is very important to us. If you do not hear back from us within two business days please email us at customerservice@wedobeauty.com.

�2010 L.A. Beautiful - All Rights Reserved

L.A. Beautiful provides cosmetic and plastic surgery, orthopedic procedures, foot and ankle procedures and pain management procedures througuout Southern California including Los Angeles, Beverly Hills, Pasadena, Newport Beach, Brea, Torrance, Encino, Irvine, Long Beach, Oxnard, Riverside, Thousand Oaks, Upland, Valencia and in Orange County, San Bernardino County, Los Angeles County, Ventura County, Riverside County and the Inland Empire.

Breast Augmentation · Breast Enhancement · Breast Enlargement · Breast Implant · Breast Lifts · Breast Reduction · Body Lifts · Chin and Cheek Augmentation · Ear Surgery · Eyelid Surgery · Facelift · Forehead Lift · Liposuction · Male Breast Reduction · Gynecomastia · Neck Lift · Rhinoplasty · Skin Tightening · Tummy Tuck