Consultation Request Form

If you are considering any of Dr. Lent’s services, whether it be surgical or non-surgical please contact us to discuss your needs. We will discreetly handle your inquiry and provide you with the necessary information so that you can make an informed decision.  Personal information is used for internal purposes only and will not be shared, sold, or otherwise distributed.

Name*
How Should We Contact You?*
Telephone
I would like to speak to Dr. Lent about the following Procedures *