Dr. David P. Rapaport has been practicing locally for the last seven years. During this period of time, he has become known as one of the finest specialists in his field throughout the United States and around the world. He is famous for his treatment of melanoma and for his cutting-edge endoscopic technique used in coronary artery bypass surgery.

Patients travel from around the globe to undergo surgery at his practice. If you are considering a procedure, consider the finest available, and contact our office today.

This form allows him to do a preliminary review of your case online. Please fill out the form to initiate this process. We will review your case and contact you as soon as possible to go over your options. Thank you for contacting our practice. Please answer all questions.

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Patient Name:

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1. List in priority the things you would most like to improve about your image.

2. Have you had any previous cosmetic surgery? (If no, go to question #3)

a. What was the reason for your surgery?

b. When was your last surgery performed?

c. Who did your surgeries? (name of doctor and specialty)

3. If you have not had another surgery, what are your realistic desires; i.e., what will/would it take for you to be satisfied with the outcome? Think about this and be honest.

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