Aesthetic treatment consultation request

Before you fill this out

Aesthetic services are offered at the Lake Oswego clinic only (460 5th St, Lake Oswego, OR 97034). The consult call is free. Treatments are not.

If you’d rather skip the form and just talk, call 503-863-2018. Monday through Friday, 9am to 4:30pm.

The form

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First name *

Last name *

Email *

Phone *

reach interested Last

What are you most interested in?Select one (optional)Emface (facial muscle & collagen)Emsculpt Neo (body composition)Emsella (pelvic floor)PRP under-eye rejuvenationRF microneedlingMicroneedlingRegenerative peptidesHair restoration (PRP)I’m not sure, want to talk through options

What are your goals? What are you trying to address?

Best way to reach youPhoneTextEmail

Health-data consent *

• I consent to Radiance Natural Medicine collecting and using the health information I share in this form to respond to my request and coordinate scheduling. Details in our privacy policy.

Send consult request

A member of the Lake Oswego team will reach out within one business day to schedule your consult. No appointment is confirmed until we’ve spoken.

What happens next

1. We call or text you back within one business day at the contact method you select.
2. Short call to scope your goals and whether what you’re asking about is the right tool. Sometimes the answer is “come in for a 30-minute consult,” sometimes it’s “the device you’re asking about isn’t actually what your concern needs.”
3. In-clinic consult at Lake Oswego if that’s the right step. Treatment plan and pricing reviewed there, in writing.