Schedule a Virtual Consultation

For the convenience of our patients, Dr. Traci Temmen offers Virtual Consultations. To schedule your appointment, please fill out the form below. For Virtual Consultations, Dr. Temmen requests patients provide some photos which you can submit on the form below.

Virtual consultation with Dr. Traci Temmen in Tampa, FL

Please fill out the form below and we will try and match you with a date and time to fit your schedule. Thank you for contacting the office of Dr. Traci Temmen.

I am interested in the following procedure:

Preferred day(s) of the week for an appointment?

Monday
Tuesday
Wednesday
Thursday

Preferred time(s) for an appointment?

9:00 am – 11:00 am
11:00 am – 1:00 pm
1:00 pm – 3:00 pm

Do you smoke?
Yes No

If you do smoke, how much per day?

Do you take drugs?
Yes No

Medications:

Allergies:

Have you given birth to children?
Yes No

If yes, how old are they?

If interested in breast surgery, current breast size/desired breast size?

If scheduling a Virtual Consultation please use the upload button below to submit photos to us. To make the most out of your Virtual Consultation, do your best to submit your photographs with multiple angles.

Accepted file types: jpg, jpeg.

*Communications through our website or via email are not encrypted and are not necessarily secure. Use of the Internet or email is for your convenience only, and by using them, you assume the risk of unauthorized use.

This form is not HIPPA compliant and all information and/or photos submitted are voluntary and for your convenience.

By checking this box you agree to the terms of use detailed above.