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Maryland Center for Facial Plastic Surgery
11350 McCormick Rd
Executive Plaza I, Suite 105
Hunt Valley, MD 21031

Centers for Advance ENT Care, LLC
6565 N Charles St. Suite 613
Baltimore, MD 21204

If you are considering one of our cosmetic surgery procedures, contact us today to schedule your consultation and get started. At Maryland Center for Facial Plastic Surgery, we proudly serve men and women in the Baltimore, Towson, and Columbia areas.

First Name*

Last Name*

Age*

Gender

Weight

Height

Phone*

Email*

How would you like us to respond?

PhoneEmail

Areas of Concern & Procedures You are Considering:

When are you hoping to have this procedure done?*

Is there an event that is motivating you?

Have you had cosmetic procedures before?
YesNo

If yes, please indicate cosmetic procedures

How long have you been thinking about a cosmetic procedure?*

On a scale of 1-10, how important is this cosmetic procedure to you? *

What are your expectations & concerns of this procedure?*

Where are you in your decision-making process?*

PLEASE USE THE UPLOAD BUTTON BELOW TO UPLOAD PHOTOS TO SEND TO US
To make the most of your virtual consultation, do your best to submit your photographs in the following format. This will allow our doctors to make the most comprehensive assessment.

1. Use a solid background.
2. Take one frontal photo with the face or body centered and looking straight.
3. Take at least one, preferably two profile photos

File formats accepted: gif | png | jpg | jpeg
File size limit: 3mb

Photos:*
[multifile* your-photos filetypes:jpg|png|jpeg]

MDCFPS has a 24 hour notification policy for cancellations and rescheduling.
There is a $50.00 fee for no shows and same day rescheduling.

By checking this box you agree to the Terms of Use listed here*
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Home » Contact Us

Contact Us

Maryland Center for Facial Plastic Surgery
11350 McCormick Rd
Executive Plaza I, Suite 105
Hunt Valley, MD 21031

Centers for Advance ENT Care, LLC
6565 N Charles St. Suite 613
Baltimore, MD 21204

First Name*

Last Name*

Age*

Gender

Weight

Height

Phone*

Email*

How would you like us to respond?

PhoneEmail

Areas of Concern & Procedures You are Considering:

When are you hoping to have this procedure done?*

Is there an event that is motivating you?

Have you had cosmetic procedures before?
YesNo

If yes, please indicate cosmetic procedures

How long have you been thinking about a cosmetic procedure?*

On a scale of 1-10, how important is this cosmetic procedure to you? *

What are your expectations & concerns of this procedure?*

Where are you in your decision-making process?*

1. Use a solid background.
2. Take one frontal photo with the face or body centered and looking straight.
3. Take at least one, preferably two profile photos

File formats accepted: gif | png | jpg | jpeg
File size limit: 3mb

Photos:*
[multifile* your-photos filetypes:jpg|png|jpeg]

MDCFPS has a 24 hour notification policy for cancellations and rescheduling.
There is a $50.00 fee for no shows and same day rescheduling.

By checking this box you agree to the Terms of Use listed here*
I Agree

SIGNATURE*

DATE*

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MEET THE DOCTOR

Samuel Hahn, M.D.

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