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hover:text-brand-black text-brand-medium-gray" href="https://artisanplasticsurgery.com/treatments/mommy-makeover-in-atlanta/" target="">Mommy Makeover</a> </li> </ul> </li> <li class="primary-menu-child-item complex"> <button class="flex group duration-200 items-center justify-between w-full text-left  primary-menu-child-item__link hdg-6 font-semibold" data-toggle-class="is-open" data-toggle-target="#child-menu-526" aria-expanded="false" data-toggle-group="child-menu-accordions" id="child-item-526"> Body <span class="inline-block"> <svg class="w-3 h-3 ml-3 duration-200 rotate-45 icon icon-cross-small group-[.is-open]:text-brand-black text-brand-medium-grey" aria-hidden="true"><use xlink:href="#icon-cross-small"></use></svg> </span> </button> <ul class="hidden pt-5 primary-menu-child-item__menu" id="child-menu-526" aria-hidden="true" aria-labelledby="item-526"> <li class="mb-3 last:mb-0"> <a class="block duration-200 primary-menu-child-item__child-link hover:text-brand-black 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hover:text-brand-black text-brand-medium-gray" href="https://artisanplasticsurgery.com/treatments/morpheus8-in-atlanta/" target="">Morpheus8</a> </li> <li class="mb-3 last:mb-0"> <a class="block duration-200 primary-menu-child-item__child-link hover:text-brand-black text-brand-medium-gray" href="https://artisanplasticsurgery.com/treatments/skinpen-in-atlanta/" target="">SkinPen</a> </li> <li class="mb-3 last:mb-0"> <a class="block duration-200 primary-menu-child-item__child-link hover:text-brand-black text-brand-medium-gray" href="https://artisanplasticsurgery.com/treatments/sylfirm-in-atlanta/" target="">Sylfirm</a> </li> <li class="mb-3 last:mb-0"> <a class="block duration-200 primary-menu-child-item__child-link hover:text-brand-black text-brand-medium-gray" href="https://artisanplasticsurgery.com/treatments/vivace-in-atlanta/" target="">Vivace</a> </li> <li class="mb-3 last:mb-0"> <a class="block duration-200 primary-menu-child-item__child-link hover:text-brand-black 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href="https://artisanplasticsurgery.com/treatments/laser-hair-removal-in-atlanta/" target="">Laser Hair Removal</a> </li> <li class="mb-3 last:mb-0"> <a class="block duration-200 primary-menu-child-item__child-link hover:text-brand-black text-brand-medium-gray" href="https://artisanplasticsurgery.com/treatments/body-sculpting-in-atlanta/" target="">CoolTone</a> </li> <li class="mb-3 last:mb-0"> <a class="block duration-200 primary-menu-child-item__child-link hover:text-brand-black text-brand-medium-gray" href="https://artisanplasticsurgery.com/treatments/thermiva-in-atlanta/" target="">ThermiVa Vaginal Rejuvenation</a> </li> <li class="mb-3 last:mb-0"> <a class="block duration-200 primary-menu-child-item__child-link hover:text-brand-black text-brand-medium-gray" href="https://artisanplasticsurgery.com/treatments/collagen-induction-in-atlanta/" target="">Sculptra BBL</a> </li> </ul> </li> <li class="primary-menu-child-item complex"> <button class="flex group duration-200 items-center 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575	--gf-color-in-ctrl-primary-contrast-rgb: 255, 255, 255;
576	--gf-color-in-ctrl-primary-darker: #001ab3;
577	--gf-color-in-ctrl-primary-lighter: #527eff;
578	--gf-color-in-ctrl-light: rgba(17, 35, 55, .1);
579	--gf-color-in-ctrl-light-rgb: 17, 35, 55;
580	--gf-color-in-ctrl-light-darker: rgba(104, 110, 119, .35);
581	--gf-color-in-ctrl-light-lighter: #f5f5f5;
582	--gf-color-in-ctrl-dark: #585e6a;
583	--gf-color-in-ctrl-dark-rgb: 88, 94, 106;
584	--gf-color-in-ctrl-dark-darker: #112337;
585	--gf-color-in-ctrl-dark-lighter: rgba(17, 35, 55, .65);
586	--gf-radius: 3px;
587	--gf-font-size-secondary: 14px;
588	--gf-font-size-tertiary: 13px;
589	--gf-icon-ctrl-number: url("data:image/svg+xml,%3Csvg width='8' height='14' viewBox='0 0 8 14' fill='none' xmlns='http://www.w3.org/2000/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M4 0C4.26522 5.96046e-08 4.51957 0.105357 4.70711 0.292893L7.70711 3.29289C8.09763 3.68342 8.09763 4.31658 7.70711 4.70711C7.31658 5.09763 6.68342 5.09763 6.29289 4.70711L4 2.41421L1.70711 4.70711C1.31658 5.09763 0.683417 5.09763 0.292893 4.70711C-0.0976311 4.31658 -0.097631 3.68342 0.292893 3.29289L3.29289 0.292893
589C3.48043 0.105357 3.73478 0 4 0ZM0.292893 9.29289C0.683417 8.90237 1.31658 8.90237 1.70711 9.29289L4 11.5858L6.29289 9.29289C6.68342 8.90237 7.31658 8.90237 7.70711 9.29289C8.09763 9.68342 8.09763 10.3166 7.70711 10.7071L4.70711 13.7071C4.31658 14.0976 3.68342 14.0976 3.29289 13.7071L0.292893 10.7071C-0.0976311 10.3166 -0.0976311 9.68342 0.292893 9.29289Z' fill='rgba(17, 35, 55, 0.65)'/%3E%3C/svg%3E");
590	--gf-icon-ctrl-select: url("data:image/svg+xml,%3Csvg width='10' height='6' viewBox='0 0 10 6' fill='none' xmlns='http://www.w3.org/2000/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M0.292893 0.292893C0.683417 -0.097631 1.31658 -0.097631 1.70711 0.292893L5 3.58579L8.29289 0.292893C8.68342 -0.0976311 9.31658 -0.0976311 9.70711 0.292893C10.0976 0.683417 10.0976 1.31658 9.70711 1.70711L5.70711 5.70711C5.31658 6.09763 4.68342 6.09763 4.29289 5.70711L0.292893 1.70711C-0.0976311 1.31658 -0.0976311 0.683418 0.292893 0.292893Z' fill='rgba(17, 35, 55, 0.65)'/%3E%3C/svg%3E");
591	--gf-icon-ctrl-search: url("data:image/svg+xml,%3Csvg width='640' height='640' xmlns='http://www.w3.org/2000/svg'%3E%3Cpath d='M256 128c-70.692 0-128 57.308-128 128 0 70.691 57.308 128 128 128 70.691 0 128-57.309 128-128 0-70.692-57.309-128-128-128zM64 256c0-106.039 85.961-192 192-192s192 85.961 192 192c0 41.466-13.146 79.863-35.498 111.248l154.125 154.125c12.496 12.496 12.496 32.758 0 45.254s-32.758 12.496-45.254 0L367.248 412.502C335.862 434.854 297.467 448 256 448c-106.039 0-192-85.962-192-192z' fill='rgba(17, 35, 55, 0.65)'/%3E%3C/svg%3E");
592	--gf-label-space-y-secondary: var(--gf-label-space-y-md-secondary);
593	--gf-ctrl-border-color: #686e77;
594	--gf-ctrl-size: var(--gf-ctrl-size-md);
595	--gf-ctrl-label-color-primary: #112337;
596	--gf-ctrl-label-color-secondary: #112337;
597	--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);
598	--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);
599	--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);
600	--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);
601	--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);
602	--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);
603	--gf-ctrl-btn-border-color-secondary: #686e77;
604	--gf-ctrl-btn-bg-color-hover-tertiary: #ebebeb;
605	--gf-field-img-choice-size: var(--gf-field-img-choice-size-md);
606	--gf-field-img-choice-card-space: var(--gf-field-img-choice-card-space-md);
607	--gf-field-img-choice-check-ind-size: var(--gf-field-img-choice-check-ind-size-md);
608	--gf-field-img-choice-check-ind-icon-size: var(--gf-field-img-choice-check-ind-icon-size-md);
609	--gf-field-pg-steps-number-color: rgba(17, 35, 55, .8);
610}
611</style> <div class='gform_heading'> <p class='gform_required_legend'>&quot;<span class="gfield_required gfield_required_asterisk">*</span>&quot; indicates required fields</p> </div><form method='post' enctype='multipart/form-data' target='gform_ajax_frame_6' id='gform_6' class='form-skin' action='/shop/' data-formid='6' novalidate> <div class='gform-body gform_body'><div id='gform_fields_6' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id="field_6_40" class="gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible ll_honeypot ll_gfield_type_honeypot " data-field-class="ll_honeypot ll_gfield_type_honeypot"><label class='gfield_label gform-field-label' for='input_6_40'><span class='gform-field-label__text'>Email</span></label><div class='ginput_container'><input name='input_40' id='input_6_40' type='text' value='' autocomplete='new-password' /></div><div class='gfield_description' id='gfield_description_6_40'>This field is for validation purposes and should be left unchanged.</div></div><div id="field_6_26" class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_html ll_gfield_type_html " data-field-class="ll_html ll_gfield_type_html"><h3 style="text-align: center;">Request a Consultation</h3> <p style="text-align: center;">Let our team know how to get in touch to scheduled your consultation. Your Artisan journey starts today! If you’re an existing patient, please call us at (404) 851-1998</p></div><fieldset id="field_6_21" class="gfield gfield--type-radio gfield--type-choice gfield--in
611put-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical ll_radio ll_gfield_type_radio ll-radio-style--toggle" data-field-class="ll_radio ll_gfield_type_radio ll-radio-style--toggle"><legend class='gfield_label gform-field-label'><span class='gform-field-label__text'>Contact Method</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_21'> <div class='gchoice gchoice_6_21_0'> <input class='gfield-choice-input' name='input_21' type='radio' value='Call Me' checked='checked' id='choice_6_21_0' onchange='gformToggleRadioOther( this )' /> <label for='choice_6_21_0' id='label_6_21_0' class='gform-field-label gform-field-label--type-inline'>Call Me</label> </div> <div class='gchoice gchoice_6_21_1'> <input class='gfield-choice-input' name='input_21' type='radio' value='Email Me' id='choice_6_21_1' onchange='gformToggleRadioOther( this )' /> <label for='choice_6_21_1' id='label_6_21_1' class='gform-field-label gform-field-label--type-inline'>Email Me</label> </div></div></div></fieldset><div id="field_6_33" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_section ll_gfield_type_section " data-field-class="ll_section ll_gfield_type_section"><h3 class="gsection_title"></h3></div><div id="field_6_22" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_text ll_gfield_type_text " data-field-class="ll_text ll_gfield_type_text"><label class='gfield_label gform-field-label' for='input_6_22'><span class='gform-field-label__text'>First Name</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_6_22' type='text' value='' class='large' aria-required="true" aria-invalid="false" /></div></div><div id="field_6_23" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_text ll_gfield_type_text " data-field-class="ll_text ll_gfield_type_text"><label class='gfield_label gform-field-label' for='input_6_23'><span class='gform-field-label__text'>Last Name</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_6_23' type='text' value='' class='large' aria-required="true" aria-invalid="false" /></div></div><div id="field_6_24" class="gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_phone ll_gfield_type_phone " data-field-class="ll_phone ll_gfield_type_phone"><label class='gfield_label gform-field-label' for='input_6_24'><span class='gform-field-label__text'>Phone Number</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_phone'><input name='input_24' id='input_6_24' type='tel' value='' class='large' placeholder='(999) 999-9999' aria-required="true" aria-invalid="false" data-mask="(999) 999-9999" /></div></div><div id="field_6_28" class="gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_email ll_gfield_type_email " data-field-class="ll_email ll_gfield_type_email"><label class='gfield_label gform-field-label' for='input_6_28'><span class='gform-field-label__text'>Email Address</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_28' id='input_6_28' type='email' value='' class='large' aria-required="true" aria-invalid="false" /> </div></div><fieldset id="field_6_35" class="gfield gfield--type-radio gfield--type-choice gfield--in
611put-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical ll_radio ll_gfield_type_radio " data-field-class="ll_radio ll_gfield_type_radio"><legend class='gfield_label gform-field-label'><span class='gform-field-label__text'>Preferred Location</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_35'> <div class='gchoice gchoice_6_35_0'> <input class='gfield-choice-input' name='input_35' type='radio' value='Northside' id='choice_6_35_0' onchange='gformToggleRadioOther( this )' /> <label for='choice_6_35_0' id='label_6_35_0' class='gform-field-label gform-field-label--type-inline'>Northside</label> </div> <div class='gchoice gchoice_6_35_1'> <input class='gfield-choice-input' name='input_35' type='radio' value='Johns Creek' id='choice_6_35_1' onchange='gformToggleRadioOther( this )' /> <label for='choice_6_35_1' id='label_6_35_1' class='gform-field-label gform-field-label--type-inline'>Johns Creek</label> </div> <div class='gchoice gchoice_6_35_2'> <input class='gfield-choice-input' name='input_35' type='radio' value='Buckhead' id='choice_6_35_2' onchange='gformToggleRadioOther( this )' /> <label for='choice_6_35_2' id='label_6_35_2' class='gform-field-label gform-field-label--type-inline'>Buckhead</label> </div> <div class='gchoice gchoice_6_35_3'> <input class='gfield-choice-input' name='input_35' type='radio' value='Westside' id='choice_6_35_3' onchange='gformToggleRadioOther( this )' /> <label for='choice_6_35_3' id='label_6_35_3' class='gform-field-label gform-field-label--type-inline'>Westside</label> </div></div></div></fieldset><div id="field_6_36" class="gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_select ll_gfield_type_select " data-field-class="ll_select ll_gfield_type_select"><label class='gfield_label gform-field-label' for='input_6_36'><span class='gform-field-label__text'>Treatment of Interest (Plastic Surgery)</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_36' id='input_6_36' class='large gfield_select' aria-required="true" aria-invalid="false"><option value='Face Surgery'>Face Surgery</option><option value='Breast Surgery'>Breast Surgery</option><option value='Body Surgery'>Body Surgery</option>
611<option value='Liposuction'>Liposuction</option><option value='Injectables'>Injectables</option></select><svg class="pointer-events-none fill-current icon icon-chevron-down select-dropdown-arrow"><use xlink:href="#icon-chevron-down"></use></svg></div></div><div id="field_6_37" class="gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_select ll_gfield_type_select " data-field-class="ll_select ll_gfield_type_select"><label class='gfield_label gform-field-label' for='input_6_37'><span class='gform-field-label__text'>Treatment of Interest (Beauté)</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_37' id='input_6_37' class='large gfield_select' aria-required="true" aria-invalid="false"><option value=''>Choose one.</option><option value='Injectables'>Injectables</option><option value='Laser Treatments'>Laser Treatments</option><option value='Microneedling'>Microneedling</option><option value='Facials'>Facials</option><option value='Peels'>Peels</option><option value='Body Contouring'>Body Contouring</option><option value='Medical Weight Loss'>Medical Weight Loss</option><option value='Hormone Optimization'>Hormone Optimization</option><option value='Vaginal Rejuvenation'>Vaginal Rejuvenation</option><option value='Comprehensive Wellness'>Comprehensive Wellness</option><option value='IV Therapy'>IV Therapy</option><option value='Peptide Treatments'>Peptide Treatments</option><option value='Hair Restoration'>Hair Restoration</option></select><svg class="pointer-events-none fill-current icon icon-chevron-down select-dropdown-arrow"><use xlink:href="#icon-chevron-down"></use></svg></div></div><div id="field_6_38" class="gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_select ll_gfield_type_select " data-field-class="ll_select ll_gfield_type_select"><label class='gfield_label gform-field-label' for='input_6_38'><span class='gform-field-label__text'>How did you hear about us?</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_38' id='input_6_38' class='large gfield_select' aria-required="true" aria-invalid="false"><option value='Social Media (Instagram, Facebook, TikTok, etc.)'>Social Media (Instagram, Facebook, TikTok, etc.)</option><option value='Newsletter'>Newsletter</option><option value='SMS'>SMS</option><option value='A Friend or Family Member'>A Friend or Family Member</option><option value='Doctor Referral'>Doctor Referral</option><option value='Walk-In / Drove By'>Walk-In / Drove By</option><option value='Google'>Google</option><option value='Other'>Other</option></select><svg class="pointer-events-none fill-current icon icon-chevron-down select-dropdown-arrow"><use xlink:href="#icon-chevron-down"></use></svg></div></div><div id="field_6_39" class="gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_text ll_gfield_type_text " data-field-class="ll_text ll_gfield_type_text"><label class='gfield_label gform-field-label' for='input_6_39'><span class='gform-field-label__text'>Other</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_39' id='input_6_39' type='text' value='' class='large' aria-required="true" aria-invalid="false" /></div></div><div id="field_6_32" class="gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_text ll_gfield_type_text " data-field-class="ll_text ll_gfield_type_text"><label class='gfield_label gform-field-label' for='input_6_32'><span class='gform-field-label__text'>Message (Optional)</span></label><div class='ginput_container ginput_container_text'><input name='input_32' id='input_6_32' type='text' value='' class='large' aria-invalid="false" /></div></div><div id="field_6_30" class="gfield gfield--type-gfsi_sources gfield--in
611put-type-gfsi_sources gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_gfsi_sources ll_gfield_type_gfsi_sources " data-field-class="ll_gfsi_sources ll_gfield_type_gfsi_sources"><input type="hidden" name="input_30" class="gfsi_source gform_hidden" id="input_30_6" value="direct" /></div><div id="field_6_34" class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_html ll_gfield_type_html " data-field-class="ll_html ll_gfield_type_html"><p style="font-size: 10px;">By providing my mobile number and clicking Submit, I consent to receive recurring automated marketing and professional text messages from Artisan Plastic Surgery at the number provided. Message frequency may vary and message & data rates may apply. Reply STOP to cancel or HELP for help. Consent is not a condition of purchase.</p></div></div></div> <div class='gform-footer gform_footer top_label'> <button class='button btn-primary ll-submit' id='gform_submit_button_6' type='submit'>Submit</button> <input type='hidden' name='gform_ajax' value='form_id=6&amp;title=&amp;description=&amp;tabindex=0&amp;theme=gravity-theme&amp;styles=[]&amp;hash=09559d341bc00ffa2464d98385e297e0' /> <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_6' value='iframe' /> <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_6' id='gform_theme_6' value='gravity-theme' /> <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_6' id='gform_style_settings_6' value='[]' /> <input type='hidden' class='gform_hidden' name='is_submit_6' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='6' /> <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='VZEjUkBGdfBYbn0yZyxPfcUALThU4PqK4dfBVOEWQTOCCft6lE7/DHDbplOwCb3bVq7HPvsX8ySXMBymQ6fmv2PCH48AvSEHm457IGOx+k5b+mU=' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_6' value='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' /> <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_6' id='gform_target_page_number_6' value='0' /> <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_6' id='gform_source_page_number_6' value='1' /> <input type='hidden' name='gform_field_values' value='' /> </div> <p style="display: none !important;" class="akismet-fields-container" data-prefix="ak_"><label>&#916;<textarea name="ak_hp_textarea" cols="45" rows="8" maxlength="100"></textarea></label><input type="hidden" id="ak_js_1" name="ak_js" value="71" />
611<script>
612document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() );
613</script>
613 </p></form> </div> <iframe style='display: none;width: 0px;height: 0px;' src='about:blank' name='gform_ajax_frame_6' id='gform_ajax_frame_6' title='This iframe contains the logic required to handle Ajax powered Gravity Forms.'></iframe> 
613<script>
614gform.initializeOnLoaded( function() {jQuery('#gform_ajax_frame_6').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_6');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_6').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){form_content.find('form').css('opacity', 0);jQuery('#gform_wrapper_6').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_6').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_6').removeClass('gform_validation_error');}setTimeout( function() { /* delay the scroll by 50 milliseconds to fix a bug in chrome */  }, 50 );var current_page = jQuery('#gform_source_page_number_6').val();jQuery(document).trigger('gform_page_loaded', [6, current_page]);window['gf_submitting_6'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}jQuery('#gform_wrapper_6').replaceWith(confirmation_content);jQuery(document).trigger('gform_confirmation_loaded', [6]);window['gf_submitting_6'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_6').text());}else{jQuery('#gform_6').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger("gform_pre_post_render", [{ formId: "6", currentPage: "current_page", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = document.getElementById( "gform_wrapper_6" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( "span" );            visibilitySpan.id = "gform_visibility_test_6";            gformWrapperDiv.insertAdjacentElement( "afterend", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( "gform_visibility_test_6" );        let postRenderFired = false;        function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 6, current_page );            if ( visibilityTestDiv ) {                visibilityTestDiv.parentNode.removeChild( visibilityTestDiv );            }        }        function debounce( func, wait, immediate ) {            var timeout;            return function() {                var context = this, args = arguments;                var later = function() {                    timeout = null;                    if ( !immediate ) func.apply( context, args );                };                var callNow = immediate && !timeout;                clearTimeout( timeout );                timeout = setTimeout( later, wait );                if ( callNow ) func.apply( context, args );            };        }        const debouncedTriggerPostRender = debounce( function() {            triggerPostRender();        }, 200 );        if ( visibilityTestDiv && visibilityTestDiv.offsetParent === null ) {            const observer = new MutationObserver( ( mutations ) => {                mutations.forEach( ( mutation ) => {                    if ( mutation.type === 'attributes' && visibilityTestDiv.offsetParent !== null ) {                        debouncedTriggerPostRender();                        observer.disconnect();                    }                });            });            observer.observe( document.body, {                attributes: true,                childList: false,                subtree: true,                attributeFilter: [ 'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} );
615</script>
615 <p></p> </div> </div> <div data-lifted-logic-popup-section class="" style="display: var(--ll-editor-modal-content-type-display);align-items: var(--ll-editor-modal-align-items);background-color: var(--ll-editor-modal-background-color-secondary);width: var(--ll-editor-modal-image-width);order: var(--ll-editor-modal-image-order);flex: 0 0 auto;padding: var(--ll-editor-modal-image-padding-top) var(--ll-editor-modal-image-padding-right) var(--ll-editor-modal-image-padding-bottom) var(--ll-editor-modal-image-padding-left);"> </div> </div> </div></template><template id="popup-request-consultation-val" data-lifted-logic-popup-template data-trigger-info="{&quot;url&quot;:&quot;popup-request-consultation-val&quot;,&quot;type&quot;:&quot;global&quot;,&quot;exclude&quot;:[],&quot;cookieId&quot;:&quot;66fc35fb225ef&quot;}"><div class="lifted-logic-popup-modal " style="--ll-editor-modal-max-width: 570px;--ll-editor-modal-background-color: #f2f0e8;--ll-editor-modal-background-color-secondary: rgba(242,240,232,1);--ll-editor-modal-border-radius: 10px;--ll-editor-modal-padding-left: 0px;--ll-editor-modal-padding-right: 0px;--ll-editor-modal-padding-top: 0px;--ll-editor-modal-padding-bottom: 0px;--ll-editor-modal-row-gap: 0px;--ll-editor-modal-column-gap: 0px;--ll-editor-modal-align-items: start;--image-height: auto;--ll-editor-modal-justify-content: center;--ll-editor-modal-order: default;--ll-editor-modal-content-order: 1;--ll-editor-modal-image-order: 2;--ll-editor-modal-content-percent: 100%;--ll-editor-modal-image-percent: 0%;--ll-editor-modal-image-fit: unset;--ll-editor-modal-content-padding-left: 30px;--ll-editor-modal-content-padding-right: 30px;--ll-editor-modal-content-padding-top: 30px;--ll-editor-modal-content-padding-bottom: 30px;--ll-editor-modal-image-padding-left: 0px;--ll-editor-modal-image-padding-right: 0px;--ll-editor-modal-image-padding-top: 0px;--ll-editor-modal-image-padding-bottom: 0px;--ll-editor-modal-close-button-color: rgba(51,51,51,1);--ll-editor-modal-content-type-display: grid;--ll-editor-modal-content-width: calc(var(--ll-editor-modal-content-percent) - ( var(--ll-editor-modal-column-gap) / 2 ));--ll-editor-modal-image-width: calc(var(--ll-editor-modal-image-percent) - ( var(--ll-editor-modal-column-gap) / 2 ));position: relative;margin: auto;border-radius: var(--ll-editor-modal-border-radius);width: 100%;max-width: var(--ll-editor-modal-max-width);overflow: hidden;padding: var(--ll-editor-modal-padding-top) var(--ll-editor-modal-padding-right) var(--ll-editor-modal-padding-bottom) var(--ll-editor-modal-padding-left);"> <div data-lifted-logic-popup-container class="" style="display: var(--ll-editor-modal-container-display,flex);flex-wrap: wrap;row-gap: var(--ll-editor-modal-row-gap);column-gap: var(--ll-editor-modal-column-gap);justify-content: var(--ll-editor-modal-justify-content);"> <div data-lifted-logic-popup-section class="" style="display: grid;align-items: var(--ll-editor-modal-align-items);flex: 0 0 auto;background-color: var(--ll-editor-modal-background-color);width: var(--ll-editor-modal-content-width);order: var(--ll-editor-modal-content-order);padding: var(--ll-editor-modal-content-padding-top) var(--ll-editor-modal-content-padding-right) var(--ll-editor-modal-content-padding-bottom) var(--ll-editor-modal-content-padding-left);"> <div class="wysiwyg "> <p style="text-align: center;"> </p><div class='gf_browser_chrome gform_wrapper gravity-theme gform-theme--no-framework form-skin_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_9' style='display: none;'><style>
616#gform_wrapper_9[data-form-index="0"].gform-theme {
617	--gf-color-primary: #204ce5;
618	--gf-color-primary-rgb: 32, 76, 229;
619	--gf-color-primary-contrast: #fff;
620	--gf-color-primary-contrast-rgb: 255, 255, 255;
621	--gf-color-primary-darker: #001ab3;
622	--gf-color-primary-lighter: #527eff;
623	--gf-color-secondary: #fff;
624	--gf-color-secondary-rgb: 255, 255, 255;
625	--gf-color-secondary-contrast: #112337;
626	--gf-color-secondary-contrast-rgb: 17, 35, 55;
627	--gf-color-secondary-darker: #f5f5f5;
628	--gf-color-secondary-lighter: #fff;
629	--gf-color-out-ctrl-light: rgba(17, 35, 55, .1);
630	--gf-color-out-ctrl-light-rgb: 17, 35, 55;
631	--gf-color-out-ctrl-light-darker: rgba(104, 110, 119, .35);
632	--gf-color-out-ctrl-light-lighter: #f5f5f5;
633	--gf-color-out-ctrl-dark: #585e6a;
634	--gf-color-out-ctrl-dark-rgb: 88, 94, 106;
635	--gf-color-out-ctrl-dark-darker: #112337;
636	--gf-color-out-ctrl-dark-lighter: rgba(17, 35, 55, .65);
637	--gf-color-in-ctrl: #fff;
638	--gf-color-in-ctrl-rgb: 255, 255, 255;
639	--gf-color-in-ctrl-contrast: #112337;
640	--gf-color-in-ctrl-contrast-rgb: 17, 35, 55;
641	--gf-color-in-ctrl-darker: #f5f5f5;
642	--gf-color-in-ctrl-lighter: #fff;
643	--gf-color-in-ctrl-primary: #204ce5;
644	--gf-color-in-ctrl-primary-rgb: 32, 76, 229;
645	--gf-color-in-ctrl-primary-contrast: #fff;
646	--gf-color-in-ctrl-primary-contrast-rgb: 255, 255, 255;
647	--gf-color-in-ctrl-primary-darker: #001ab3;
648	--gf-color-in-ctrl-primary-lighter: #527eff;
649	--gf-color-in-ctrl-light: rgba(17, 35, 55, .1);
650	--gf-color-in-ctrl-light-rgb: 17, 35, 55;
651	--gf-color-in-ctrl-light-darker: rgba(104, 110, 119, .35);
652	--gf-color-in-ctrl-light-lighter: #f5f5f5;
653	--gf-color-in-ctrl-dark: #585e6a;
654	--gf-color-in-ctrl-dark-rgb: 88, 94, 106;
655	--gf-color-in-ctrl-dark-darker: #112337;
656	--gf-color-in-ctrl-dark-lighter: rgba(17, 35, 55, .65);
657	--gf-radius: 3px;
658	--gf-font-size-secondary: 14px;
659	--gf-font-size-tertiary: 13px;
660	--gf-icon-ctrl-number: url("data:image/svg+xml,%3Csvg width='8' height='14' viewBox='0 0 8 14' fill='none' xmlns='http://www.w3.org/2000/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M4 0C4.26522 5.96046e-08 4.51957 0.105357 4.70711 0.292893L7.70711 3.29289C8.09763 3.68342 8.09763 4.31658 7.70711 4.70711C7.31658 5.09763 6.68342 5.09763 6.29289 4.70711L4 2.41421L1.70711 4.70711C1.31658 5.09763 0.683417 5.09763 0.292893 4.70711C-0.0976311 4.31658 -0.097631 3.68342 0.292893 3.29289L3.29289 0.292893
660C3.48043 0.105357 3.73478 0 4 0ZM0.292893 9.29289C0.683417 8.90237 1.31658 8.90237 1.70711 9.29289L4 11.5858L6.29289 9.29289C6.68342 8.90237 7.31658 8.90237 7.70711 9.29289C8.09763 9.68342 8.09763 10.3166 7.70711 10.7071L4.70711 13.7071C4.31658 14.0976 3.68342 14.0976 3.29289 13.7071L0.292893 10.7071C-0.0976311 10.3166 -0.0976311 9.68342 0.292893 9.29289Z' fill='rgba(17, 35, 55, 0.65)'/%3E%3C/svg%3E");
661	--gf-icon-ctrl-select: url("data:image/svg+xml,%3Csvg width='10' height='6' viewBox='0 0 10 6' fill='none' xmlns='http://www.w3.org/2000/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M0.292893 0.292893C0.683417 -0.097631 1.31658 -0.097631 1.70711 0.292893L5 3.58579L8.29289 0.292893C8.68342 -0.0976311 9.31658 -0.0976311 9.70711 0.292893C10.0976 0.683417 10.0976 1.31658 9.70711 1.70711L5.70711 5.70711C5.31658 6.09763 4.68342 6.09763 4.29289 5.70711L0.292893 1.70711C-0.0976311 1.31658 -0.0976311 0.683418 0.292893 0.292893Z' fill='rgba(17, 35, 55, 0.65)'/%3E%3C/svg%3E");
662	--gf-icon-ctrl-search: url("data:image/svg+xml,%3Csvg width='640' height='640' xmlns='http://www.w3.org/2000/svg'%3E%3Cpath d='M256 128c-70.692 0-128 57.308-128 128 0 70.691 57.308 128 128 128 70.691 0 128-57.309 128-128 0-70.692-57.309-128-128-128zM64 256c0-106.039 85.961-192 192-192s192 85.961 192 192c0 41.466-13.146 79.863-35.498 111.248l154.125 154.125c12.496 12.496 12.496 32.758 0 45.254s-32.758 12.496-45.254 0L367.248 412.502C335.862 434.854 297.467 448 256 448c-106.039 0-192-85.962-192-192z' fill='rgba(17, 35, 55, 0.65)'/%3E%3C/svg%3E");
663	--gf-label-space-y-secondary: var(--gf-label-space-y-md-secondary);
664	--gf-ctrl-border-color: #686e77;
665	--gf-ctrl-size: var(--gf-ctrl-size-md);
666	--gf-ctrl-label-color-primary: #112337;
667	--gf-ctrl-label-color-secondary: #112337;
668	--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);
669	--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);
670	--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);
671	--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);
672	--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);
673	--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);
674	--gf-ctrl-btn-border-color-secondary: #686e77;
675	--gf-ctrl-btn-bg-color-hover-tertiary: #ebebeb;
676	--gf-field-img-choice-size: var(--gf-field-img-choice-size-md);
677	--gf-field-img-choice-card-space: var(--gf-field-img-choice-card-space-md);
678	--gf-field-img-choice-check-ind-size: var(--gf-field-img-choice-check-ind-size-md);
679	--gf-field-img-choice-check-ind-icon-size: var(--gf-field-img-choice-check-ind-icon-size-md);
680	--gf-field-pg-steps-number-color: rgba(17, 35, 55, .8);
681}
682</style> <div class='gform_heading'> <p class='gform_required_legend'>&quot;<span class="gfield_required gfield_required_asterisk">*</span>&quot; indicates required fields</p> </div><form method='post' enctype='multipart/form-data' target='gform_ajax_frame_9' id='gform_9' class='form-skin' action='/shop/' data-formid='9' novalidate> <div class='gform-body gform_body'><div id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id="field_9_40" class="gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible ll_honeypot ll_gfield_type_honeypot " data-field-class="ll_honeypot ll_gfield_type_honeypot"><label class='gfield_label gform-field-label' for='input_9_40'><span class='gform-field-label__text'>Comments</span></label><div class='ginput_container'><input name='input_40' id='input_9_40' type='text' value='' autocomplete='new-password' /></div><div class='gfield_description' id='gfield_description_9_40'>This field is for validation purposes and should be left unchanged.</div></div><div id="field_9_26" class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_html ll_gfield_type_html " data-field-class="ll_html ll_gfield_type_html"><h3 style="text-align: center;">Request a Consultation</h3> <p style="text-align: center;">Let our team know how to get in touch to schedule your consultation with Dr. Val.</p></div><fieldset id="field_9_21" class="gfield gfield--type-radio gfield--type-choice gfield--in
682put-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical ll_radio ll_gfield_type_radio ll-radio-style--toggle" data-field-class="ll_radio ll_gfield_type_radio ll-radio-style--toggle"><legend class='gfield_label gform-field-label'><span class='gform-field-label__text'>Contact Method</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_21'> <div class='gchoice gchoice_9_21_0'> <input class='gfield-choice-input' name='input_21' type='radio' value='Call Me' checked='checked' id='choice_9_21_0' onchange='gformToggleRadioOther( this )' /> <label for='choice_9_21_0' id='label_9_21_0' class='gform-field-label gform-field-label--type-inline'>Call Me</label> </div> <div class='gchoice gchoice_9_21_1'> <input class='gfield-choice-input' name='input_21' type='radio' value='Email Me' id='choice_9_21_1' onchange='gformToggleRadioOther( this )' /> <label for='choice_9_21_1' id='label_9_21_1' class='gform-field-label gform-field-label--type-inline'>Email Me</label> </div></div></div></fieldset><div id="field_9_33" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_section ll_gfield_type_section " data-field-class="ll_section ll_gfield_type_section"><h3 class="gsection_title"></h3></div><div id="field_9_22" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_text ll_gfield_type_text " data-field-class="ll_text ll_gfield_type_text"><label class='gfield_label gform-field-label' for='input_9_22'><span class='gform-field-label__text'>First Name</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_9_22' type='text' value='' class='large' aria-required="true" aria-invalid="false" /></div></div><div id="field_9_23" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_text ll_gfield_type_text " data-field-class="ll_text ll_gfield_type_text"><label class='gfield_label gform-field-label' for='input_9_23'><span class='gform-field-label__text'>Last Name</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_9_23' type='text' value='' class='large' aria-required="true" aria-invalid="false" /></div></div><div id="field_9_24" class="gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_phone ll_gfield_type_phone " data-field-class="ll_phone ll_gfield_type_phone"><label class='gfield_label gform-field-label' for='input_9_24'><span class='gform-field-label__text'>Phone Number</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_phone'><input name='input_24' id='input_9_24' type='tel' value='' class='large' placeholder='(999) 999-9999' aria-required="true" aria-invalid="false" data-mask="(999) 999-9999" /></div></div><div id="field_9_28" class="gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_email ll_gfield_type_email " data-field-class="ll_email ll_gfield_type_email"><label class='gfield_label gform-field-label' for='input_9_28'><span class='gform-field-label__text'>Email Address</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_28' id='input_9_28' type='email' value='' class='large' aria-required="true" aria-invalid="false" /> </div></div><fieldset id="field_9_35" class="gfield gfield--type-radio gfield--type-choice gfield--in
682put-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical ll_radio ll_gfield_type_radio " data-field-class="ll_radio ll_gfield_type_radio"><legend class='gfield_label gform-field-label'><span class='gform-field-label__text'>Preferred Location</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_35'> <div class='gchoice gchoice_9_35_0'> <input class='gfield-choice-input' name='input_35' type='radio' value='Northside' id='choice_9_35_0' onchange='gformToggleRadioOther( this )' /> <label for='choice_9_35_0' id='label_9_35_0' class='gform-field-label gform-field-label--type-inline'>Northside</label> </div> <div class='gchoice gchoice_9_35_1'> <input class='gfield-choice-input' name='input_35' type='radio' value='Johns Creek' id='choice_9_35_1' onchange='gformToggleRadioOther( this )' /> <label for='choice_9_35_1' id='label_9_35_1' class='gform-field-label gform-field-label--type-inline'>Johns Creek</label> </div> <div class='gchoice gchoice_9_35_2'> <input class='gfield-choice-input' name='input_35' type='radio' value='Buckhead' id='choice_9_35_2' onchange='gformToggleRadioOther( this )' /> <label for='choice_9_35_2' id='label_9_35_2' class='gform-field-label gform-field-label--type-inline'>Buckhead</label> </div> <div class='gchoice gchoice_9_35_3'> <input class='gfield-choice-input' name='input_35' type='radio' value='Westside' id='choice_9_35_3' onchange='gformToggleRadioOther( this )' /> <label for='choice_9_35_3' id='label_9_35_3' class='gform-field-label gform-field-label--type-inline'>Westside</label> </div></div></div></fieldset><div id="field_9_36" class="gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_select ll_gfield_type_select " data-field-class="ll_select ll_gfield_type_select"><label class='gfield_label gform-field-label' for='input_9_36'><span class='gform-field-label__text'>Treatment of Interest (Plastic Surgery)</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_36' id='input_9_36' class='large gfield_select' aria-required="true" aria-invalid="false"><option value='Face Surgery'>Face Surgery</option><option value='Breast Surgery'>Breast Surgery</option><option value='Body Surgery'>Body Surgery</option>
682<option value='Liposuction'>Liposuction</option><option value='Injectables'>Injectables</option></select><svg class="pointer-events-none fill-current icon icon-chevron-down select-dropdown-arrow"><use xlink:href="#icon-chevron-down"></use></svg></div></div><div id="field_9_37" class="gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_select ll_gfield_type_select " data-field-class="ll_select ll_gfield_type_select"><label class='gfield_label gform-field-label' for='input_9_37'><span class='gform-field-label__text'>Treatment of Interest (Beauté)</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_37' id='input_9_37' class='large gfield_select' aria-required="true" aria-invalid="false"><option value=''>Choose one.</option><option value='Injectables'>Injectables</option><option value='Laser Treatments'>Laser Treatments</option><option value='Microneedling'>Microneedling</option><option value='Facials'>Facials</option><option value='Peels'>Peels</option><option value='Body Contouring'>Body Contouring</option><option value='Medical Weight Loss'>Medical Weight Loss</option><option value='Hormone Optimization'>Hormone Optimization</option><option value='Vaginal Rejuvenation'>Vaginal Rejuvenation</option><option value='Comprehensive Wellness'>Comprehensive Wellness</option><option value='IV Therapy'>IV Therapy</option><option value='Peptide Treatments'>Peptide Treatments</option><option value='Hair Restoration'>Hair Restoration</option></select><svg class="pointer-events-none fill-current icon icon-chevron-down select-dropdown-arrow"><use xlink:href="#icon-chevron-down"></use></svg></div></div><fieldset id="field_9_38" class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical ll_checkbox ll_gfield_type_checkbox " data-field-class="ll_checkbox ll_gfield_type_checkbox"><legend class='gfield_label gform-field-label gfield_label_before_complex'><span class='gform-field-label__text'>How did you hear about us?</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_38'><div class='gchoice gchoice_9_38_1'> <input class='gfield-choice-input' name='input_38.1' type='checkbox' value='Social Media (Instagram, Facebook, TikTok, etc.)' id='choice_9_38_1' /> <label for='choice_9_38_1' id='label_9_38_1' class='gform-field-label gform-field-label--type-inline'><svg class='fill-current icon icon-checkbox'><use xlink:href='#icon-checkbox'></use></svg><svg class='fill-current icon icon-checkbox-checked'><use xlink:href='#icon-checkbox-checked'></use></svg>Social Media (Instagram, Facebook, TikTok, etc.)</label> </div><div class='gchoice gchoice_9_38_2'> <input class='gfield-choice-input' name='input_38.2' type='checkbox' value='Newsletter' id='choice_9_38_2' /> <label for='choice_9_38_2' id='label_9_38_2' class='gform-field-label gform-field-label--type-inline'><svg class='fill-current icon icon-checkbox'><use xlink:href='#icon-checkbox'></use></svg><svg class='fill-current icon icon-checkbox-checked'><use xlink:href='#icon-checkbox-checked'></use></svg>Newsletter</label> </div><div class='gchoice gchoice_9_38_3'> <input class='gfield-choice-input' name='input_38.3' type='checkbox' value='SMS' id='choice_9_38_3' /> <label for='choice_9_38_3' id='label_9_38_3' class='gform-field-label gform-field-label--type-inline'><svg class='fill-current icon icon-checkbox'><use xlink:href='#icon-checkbox'></use></svg><svg class='fill-current icon icon-checkbox-checked'><use xlink:href='#icon-checkbox-checked'></use></svg>SMS</label> </div><div class='gchoice gchoice_9_38_4'> <input class='gfield-choice-input' name='input_38.4' type='checkbox' value='A Friend or Family Member' id='choice_9_38_4' /> <label for='choice_9_38_4' id='label_9_38_4' class='gform-field-label gform-field-label--type-inline'><svg class='fill-current icon icon-checkbox'><use xlink:href='#icon-checkbox'></use></svg><svg class='fill-current icon icon-checkbox-checked'><use xlink:href='#icon-checkbox-checked'></use></svg>A Friend or Family Member</label> </div><div class='gchoice gchoice_9_38_5'> <input class='gfield-choice-input' name='input_38.5' type='checkbox' value='Doctor Referral' id='choice_9_38_5' /> <label for='choice_9_38_5' id='label_9_38_5' class='gform-field-label gform-field-label--type-inline'><svg class='fill-current icon icon-checkbox'><use xlink:href='#icon-checkbox'></use></svg><svg class='fill-current icon icon-checkbox-checked'><use xlink:href='#icon-checkbox-checked'></use></svg>Doctor Referral</label> </div><div class='gchoice gchoice_9_38_6'> <input class='gfield-choice-input' name='input_38.6' type='checkbox' value='Walk-In / Drove By' id='choice_9_38_6' /> <label for='choice_9_38_6' id='label_9_38_6' class='gform-field-label gform-field-label--type-inline'><svg class='fill-current icon icon-checkbox'><use xlink:href='#icon-checkbox'></use></svg><svg class='fill-current icon icon-checkbox-checked'><use xlink:href='#icon-checkbox-checked'></use></svg>Walk-In / Drove By</label> </div><div class='gchoice gchoice_9_38_7'> <input class='gfield-choice-input' name='input_38.7' type='checkbox' value='Google' id='choice_9_38_7' /> <label for='choice_9_38_7' id='label_9_38_7' class='gform-field-label gform-field-label--type-inline'><svg class='fill-current icon icon-checkbox'><use xlink:href='#icon-checkbox'></use></svg><svg class='fill-current icon icon-checkbox-checked'><use xlink:href='#icon-checkbox-checked'></use></svg>Google</label> </div><div class='gchoice gchoice_9_38_8'> <input class='gfield-choice-input' name='input_38.8' type='checkbox' value='Other' id='choice_9_38_8' />
682 <label for='choice_9_38_8' id='label_9_38_8' class='gform-field-label gform-field-label--type-inline'><svg class='fill-current icon icon-checkbox'><use xlink:href='#icon-checkbox'></use></svg><svg class='fill-current icon icon-checkbox-checked'><use xlink:href='#icon-checkbox-checked'></use></svg>Other</label> </div></div></div></fieldset><div id="field_9_39" class="gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_text ll_gfield_type_text " data-field-class="ll_text ll_gfield_type_text"><label class='gfield_label gform-field-label' for='input_9_39'><span class='gform-field-label__text'>Other</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_39' id='input_9_39' type='text' value='' class='large' aria-required="true" aria-invalid="false" /></div></div><div id="field_9_32" class="gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_text ll_gfield_type_text " data-field-class="ll_text ll_gfield_type_text"><label class='gfield_label gform-field-label' for='input_9_32'><span class='gform-field-label__text'>Message (Optional)</span></label><div class='ginput_container ginput_container_text'><input name='input_32' id='input_9_32' type='text' value='' class='large' aria-invalid="false" /></div></div><div id="field_9_30" class="gfield gfield--type-gfsi_sources gfield--input-type-gfsi_sources gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_gfsi_sources ll_gfield_type_gfsi_sources " data-field-class="ll_gfsi_sources ll_gfield_type_gfsi_sources"><input type="hidden" name="input_30" class="gfsi_source gform_hidden" id="input_30_9" value="direct" /></div><div id="field_9_34" class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_html ll_gfield_type_html " data-field-class="ll_html ll_gfield_type_html"><p style="font-size: 10px;">By providing my mobile number and clicking Submit, I consent to receive recurring automated marketing and professional text messages from Artisan Plastic Surgery at the number provided. Message frequency may vary and message & data rates may apply. Reply STOP to cancel or HELP for help. Consent is not a condition of purchase.</p></div></div></div> <div class='gform-footer gform_footer top_label'> <button class='button btn-primary ll-submit' id='gform_submit_button_9' type='submit'>Submit</button> <input type='hidden' name='gform_ajax' value='form_id=9&amp;title=&amp;description=&amp;tabindex=0&amp;theme=gravity-theme&amp;styles=[]&amp;hash=edd6264313e61f69a11882fb85e6acd3' /> <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_9' value='iframe' /> <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_9' id='gform_theme_9' value='gravity-theme' /> <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_9' id='gform_style_settings_9' value='[]' /> <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='9' /> <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='ib1yzACe/qwDxs3o1X8hypJ15worfX/3JUuZWW2NILnyZX20umG3k+AbUa69vbdRUcNFN8THCGNwxSEK11DItAnfxshXz+wGqXIgxPJ91mVCekA=' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_9' value='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682<script>
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684 </p></form> </div> <iframe style='display: none;width: 0px;height: 0px;' src='about:blank' name='gform_ajax_frame_9' id='gform_ajax_frame_9' title='This iframe contains the logic required to handle Ajax powered Gravity Forms.'></iframe> 
684<script>
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686</script>
686 <p></p> </div> </div> <div data-lifted-logic-popup-section class="" style="display: var(--ll-editor-modal-content-type-display);align-items: var(--ll-editor-modal-align-items);background-color: var(--ll-editor-modal-background-color-secondary);width: var(--ll-editor-modal-image-width);order: var(--ll-editor-modal-image-order);flex: 0 0 auto;padding: var(--ll-editor-modal-image-padding-top) var(--ll-editor-modal-image-padding-right) var(--ll-editor-modal-image-padding-bottom) var(--ll-editor-modal-image-padding-left);"> </div> </div> </div></template><template id="popup-request-consultation-dr-val" data-lifted-logic-popup-template data-trigger-info="{&quot;url&quot;:&quot;popup-request-consultation-dr-val&quot;,&quot;type&quot;:&quot;global&quot;,&quot;exclude&quot;:[],&quot;cookieId&quot;:&quot;66fc35fb225ef&quot;}"><div class="lifted-logic-popup-modal " style="--ll-editor-modal-max-width: 650px;--ll-editor-modal-background-color: #fff;--ll-editor-modal-background-color-secondary: rgba(242,240,232,1);--ll-editor-modal-border-radius: 10px;--ll-editor-modal-padding-left: 0px;--ll-editor-modal-padding-right: 0px;--ll-editor-modal-padding-top: 0px;--ll-editor-modal-padding-bottom: 0px;--ll-editor-modal-row-gap: 0px;--ll-editor-modal-column-gap: 0px;--ll-editor-modal-align-items: start;--image-height: auto;--ll-editor-modal-justify-content: center;--ll-editor-modal-order: default;--ll-editor-modal-content-order: 1;--ll-editor-modal-image-order: 2;--ll-editor-modal-content-percent: 100%;--ll-editor-modal-image-percent: 0%;--ll-editor-modal-image-fit: unset;--ll-editor-modal-content-padding-left: 0px;--ll-editor-modal-content-padding-right: 0px;--ll-editor-modal-content-padding-top: 30px;--ll-editor-modal-content-padding-bottom: 0px;--ll-editor-modal-image-padding-left: 0px;--ll-editor-modal-image-padding-right: 0px;--ll-editor-modal-image-padding-top: 0px;--ll-editor-modal-image-padding-bottom: 0px;--ll-editor-modal-close-button-color: rgba(51,51,51,1);--ll-editor-modal-content-type-display: none;--ll-editor-modal-content-width: calc(var(--ll-editor-modal-content-percent) - ( var(--ll-editor-modal-column-gap) / 2 ));--ll-editor-modal-image-width: calc(var(--ll-editor-modal-image-percent) - ( var(--ll-editor-modal-column-gap) / 2 ));position: relative;margin: auto;border-radius: var(--ll-editor-modal-border-radius);width: 100%;max-width: var(--ll-editor-modal-max-width);overflow: hidden;padding: var(--ll-editor-modal-padding-top) var(--ll-editor-modal-padding-right) var(--ll-editor-modal-padding-bottom) var(--ll-editor-modal-padding-left);"> <div data-lifted-logic-popup-container class="" style="display: var(--ll-editor-modal-container-display,flex);flex-wrap: wrap;row-gap: var(--ll-editor-modal-row-gap);column-gap: var(--ll-editor-modal-column-gap);justify-content: var(--ll-editor-modal-justify-content);"> <div data-lifted-logic-popup-section class="" style="display: grid;align-items: var(--ll-editor-modal-align-items);flex: 0 0 auto;background-color: var(--ll-editor-modal-background-color);width: var(--ll-editor-modal-content-width);order: var(--ll-editor-modal-content-order);padding: var(--ll-editor-modal-content-padding-top) var(--ll-editor-modal-content-padding-right) var(--ll-editor-modal-content-padding-bottom) var(--ll-editor-modal-content-padding-left);"> <div class="wysiwyg "> <p><iframe src="https://go.artisanplasticsurgery.com/widget/form/ukeh3G6DS23pvThtg4zM" style="width: 100%;height: 100%;border: none;border-radius: 3px;" id="inline-ukeh3G6DS23pvThtg4zM" data-layout="{'id':'INLINE'}" data-trigger-type="alwaysShow" data-trigger-value="" data-activation-type="alwaysActivated" data-activation-value="" data-deactivation-type="neverDeactivate" data-deactivation-value="" data-form-name="Dr. Val Landing Page Form" data-height="802" data-layout-iframe-id="inline-ukeh3G6DS23pvThtg4zM" data-form-id="ukeh3G6DS23pvThtg4zM" title="Dr. Val Landing Page Form"><br /> </iframe><br /> 
686<script src="https://cdn-ilelehp.nitrocdn.com/MmoFRkyETbGMhubTroDlJAXufEzIoIIb/assets/static/optimized/rev-330bd18/go.artisanplasticsurgery.com/js/render-blocking-form_embed.js"></script>
686</p> </div> </div> <div data-lifted-logic-popup-section class="" style="display: var(--ll-editor-modal-content-type-display);align-items: var(--ll-editor-modal-align-items);background-color: var(--ll-editor-modal-background-color-secondary);width: var(--ll-editor-modal-image-width);order: var(--ll-editor-modal-image-order);flex: 0 0 auto;padding: var(--ll-editor-modal-image-padding-top) var(--ll-editor-modal-image-padding-right) var(--ll-editor-modal-image-padding-bottom) var(--ll-editor-modal-image-padding-left);"> </div> </div> </div></template><template id="popup-book-now-old" data-lifted-logic-popup-template data-trigger-info="{&quot;url&quot;:&quot;popup-book-now-old&quot;,&quot;type&quot;:&quot;global&quot;,&quot;exclude&quot;:[],&quot;cookieId&quot;:&quot;67fff126b6bc4&quot;}"><div class="lifted-logic-popup-modal " style="--ll-editor-modal-max-width: 1300px;--ll-editor-modal-background-color: #7a5f32;--ll-editor-modal-background-color-secondary: rgba(242,240,232,1);--ll-editor-modal-border-radius: 10px;--ll-editor-modal-padding-left: 0px;--ll-editor-modal-padding-right: 0px;--ll-editor-modal-padding-top: 0px;--ll-editor-modal-padding-bottom: 0px;--ll-editor-modal-row-gap: 0px;--ll-editor-modal-column-gap: 0px;--ll-editor-modal-align-items: center;--image-height: auto;--ll-editor-modal-justify-content: center;--ll-editor-modal-order: default;--ll-editor-modal-content-order: 1;--ll-editor-modal-image-order: 2;--ll-editor-modal-content-percent: 50%;--ll-editor-modal-image-percent: 50%;--ll-editor-modal-image-fit: unset;--ll-editor-modal-content-padding-left: 30px;--ll-editor-modal-content-padding-right: 30px;--ll-editor-modal-content-padding-top: 30px;--ll-editor-modal-content-padding-bottom: 30px;--ll-editor-modal-image-padding-left: 30px;--ll-editor-modal-image-padding-right: 30px;--ll-editor-modal-image-padding-top: 30px;--ll-editor-modal-image-padding-bottom: 30px;--ll-editor-modal-close-button-color: rgba(51,51,51,1);--ll-editor-modal-content-type-display: grid;--ll-editor-modal-content-width: calc(var(--ll-editor-modal-content-percent) - ( var(--ll-editor-modal-column-gap) / 2 ));--ll-editor-modal-image-width: calc(var(--ll-editor-modal-image-percent) - ( var(--ll-editor-modal-column-gap) / 2 ));position: relative;margin: auto;border-radius: var(--ll-editor-modal-border-radius);width: 100%;max-width: var(--ll-editor-modal-max-width);overflow: hidden;padding: var(--ll-editor-modal-padding-top) var(--ll-editor-modal-padding-right) var(--ll-editor-modal-padding-bottom) var(--ll-editor-modal-padding-left);"> <div data-lifted-logic-popup-container class="" style="display: var(--ll-editor-modal-container-display,flex);flex-wrap: wrap;row-gap: var(--ll-editor-modal-row-gap);column-gap: var(--ll-editor-modal-column-gap);justify-content: var(--ll-editor-modal-justify-content);"> <div data-lifted-logic-popup-section class="" style="display: grid;align-items: var(--ll-editor-modal-align-items);flex: 0 0 auto;background-color: var(--ll-editor-modal-background-color);width: var(--ll-editor-modal-content-width);order: var(--ll-editor-modal-content-order);padding: var(--ll-editor-modal-content-padding-top) var(--ll-editor-modal-content-padding-right) var(--ll-editor-modal-content-padding-bottom) var(--ll-editor-modal-content-padding-left);"> <div class="wysiwyg "> <p class="hdg-3 text-white" style="text-align: center;">Book Online Now</p> <p style="text-align: center;"><a class="btn-primary" href="https://artisanplasticsurgery.com/book-online/">Book Now</a></p> </div> </div> <div data-lifted-logic-popup-section class="" style="display: var(--ll-editor-modal-content-type-display);align-items: var(--ll-editor-modal-align-items);background-color: var(--ll-editor-modal-background-color-secondary);width: var(--ll-editor-modal-image-width);order: var(--ll-editor-modal-image-order);flex: 0 0 auto;padding: var(--ll-editor-modal-image-padding-top) var(--ll-editor-modal-image-padding-right) var(--ll-editor-modal-image-padding-bottom) var(--ll-editor-modal-image-padding-left);"> <div class="wysiwyg "> <p style="text-align: center;"> </p><div class='gf_browser_chrome gform_wrapper gravity-theme gform-theme--no-framework form-skin_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_3' style='display: none;'><style>
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729	--gf-font-size-secondary: 14px;
730	--gf-font-size-tertiary: 13px;
731	--gf-icon-ctrl-number: url("data:image/svg+xml,%3Csvg width='8' height='14' viewBox='0 0 8 14' fill='none' xmlns='http://www.w3.org/2000/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M4 0C4.26522 5.96046e-08 4.51957 0.105357 4.70711 0.292893L7.70711 3.29289C8.09763 3.68342 8.09763 4.31658 7.70711 4.70711C7.31658 5.09763 6.68342 5.09763 6.29289 4.70711L4 2.41421L1.70711 4.70711C1.31658 5.09763 0.683417 5.09763 0.292893 4.70711C-0.0976311 4.31658 -0.097631 3.68342 0.292893 3.29289L3.29289 0.292893C3.48043 0.105357 3.73478 0 4 0ZM0.292893 9.29289C0.683417 8.90237 1.31658 8.90237 1.70711 9.29289L4 11.5858L6.29289 9.29289C6.68342 8.90237 7.31658 8.90237 7.70711 9.29289C8.09763 9.68342 8.09763 10.3166 7.70711 10.7071L4.70711 13.7071C4.31658 14.0976 3.68342 14.0976 3.29289 13.7071L0.292893 10.7071C-0.0976311 10.3166 -0.0976311 9.68342 0.292893 9.29289Z' fill='rgba(17, 35, 55, 0.65)'/%3E%3C/svg%3E");
732	--gf-icon-ctrl-select: url("data:image/svg+xml,%3Csvg width='10' height='6' viewBox='0 0 10 6' fill='none' xmlns='http://www.w3.org/2000/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M0.292893 0.292893C0.683417 -0.097631 1.31658 -0.097631 1.70711 0.292893L5 3.58579L8.29289 0.292893C8.68342 -0.0976311 9.31658 -0.0976311 9.70711 0.292893C10.0976 0.683417 10.0976 1.31658 9.70711 1.70711L5.70711 5.70711C5.31658 6.09763 4.68342 6.09763 4.29289 5.70711L0.292893 1.70711C-0.0976311 1.31658 -0.0976311 0.683418 0.292893 0.292893Z' fill='rgba(17, 35, 55, 0.65)'/%3E%3C/svg%3E");
733	--gf-icon-ctrl-search: url("data:image/svg+xml,%3Csvg width='640' height='640' xmlns='http://www.w3.org/2000/svg'%3E%3Cpath d='M256 128c-70.692 0-128 57.308-128 128 0 70.691 57.308 128 128 128 70.691 0 128-57.309 128-128 0-70.692-57.309-128-128-128zM64 256c0-106.039 85.961-192 192-192s192 85.961 192 192c0 41.466-13.146 79.863-35.498 111.248l154.125 154.125c12.496 12.496 12.496 32.758 0 45.254s-32.758 12.496-45.254 0L367.248 412.502C335.862 434.854 297.467 448 256 448c-106.039 0-192-85.962-192-192z' fill='rgba(17, 35, 55, 0.65)'/%3E%3C/svg%3E");
734	--gf-label-space-y-secondary: var(--gf-label-space-y-md-secondary);
735	--gf-ctrl-border-color: #686e77;
736	--gf-ctrl-size: var(--gf-ctrl-size-md);
737	--gf-ctrl-label-color-primary: #112337;
738	--gf-ctrl-label-color-secondary: #112337;
739	--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);
740	--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);
741	--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);
742	--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);
743	--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);
744	--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);
745	--gf-ctrl-btn-border-color-secondary: #686e77;
746	--gf-ctrl-btn-bg-color-hover-tertiary: #ebebeb;
747	--gf-field-img-choice-size: var(--gf-field-img-choice-size-md);
748	--gf-field-img-choice-card-space: var(--gf-field-img-choice-card-space-md);
749	--gf-field-img-choice-check-ind-size: var(--gf-field-img-choice-check-ind-size-md);
750	--gf-field-img-choice-check-ind-icon-size: var(--gf-field-img-choice-check-ind-icon-size-md);
751	--gf-field-pg-steps-number-color: rgba(17, 35, 55, .8);
752}
753</style> <div class='gform_heading'> <p class='gform_required_legend'>&quot;
753<span class="gfield_required gfield_required_asterisk">*</span>&quot; indicates required fields</p> </div><form method='post' enctype='multipart/form-data' target='gform_ajax_frame_3' id='gform_3' class='form-skin' action='/shop/' data-formid='3' novalidate> <div class='gform-body gform_body'><div id='gform_fields_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id="field_3_41" class="gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible ll_honeypot ll_gfield_type_honeypot " data-field-class="ll_honeypot ll_gfield_type_honeypot"><label class='gfield_label gform-field-label' for='input_3_41'><span class='gform-field-label__text'>Email</span></label><div class='ginput_container'><input name='input_41' id='input_3_41' type='text' value='' autocomplete='new-password' /></div><div class='gfield_description' id='gfield_description_3_41'>This field is for validation purposes and should be left unchanged.</div></div><div id="field_3_26" class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_html ll_gfield_type_html " data-field-class="ll_html ll_gfield_type_html"><h3 style="text-align: center;">Request an Appointment</h3> <p style="text-align: center;">Let our team know how to get in touch to book your appointment. Your Artisan journey starts today!</p></div><div id="field_3_32" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_section ll_gfield_type_section " data-field-class="ll_section ll_gfield_type_section"><h3 class="gsection_title"></h3></div><div id="field_3_22" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_text ll_gfield_type_text " data-field-class="ll_text ll_gfield_type_text"><label class='gfield_label gform-field-label' for='input_3_22'><span class='gform-field-label__text'>First Name</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_3_22' type='text' value='' class='large' aria-required="true" aria-invalid="false" /></div></div><div id="field_3_23" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_text ll_gfield_type_text " data-field-class="ll_text ll_gfield_type_text"><label class='gfield_label gform-field-label' for='input_3_23'><span class='gform-field-label__text'>Last Name</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_3_23' type='text' value='' class='large' aria-required="true" aria-invalid="false" /></div></div><div id="field_3_24" class="gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_phone ll_gfield_type_phone " data-field-class="ll_phone ll_gfield_type_phone"><label class='gfield_label gform-field-label' for='input_3_24'><span class='gform-field-label__text'>Phone Number</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_phone'><input name='input_24' id='input_3_24' type='tel' value='' class='large' placeholder='(999) 999-9999' aria-required="true" aria-invalid="false" data-mask="(999) 999-9999" /></div></div><div id="field_3_28" class="gfield gfield--type-email gfield--in
753put-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_email ll_gfield_type_email " data-field-class="ll_email ll_gfield_type_email"><label class='gfield_label gform-field-label' for='input_3_28'><span class='gform-field-label__text'>Email Address</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_28' id='input_3_28' type='email' value='' class='large' aria-required="true" aria-invalid="false" /> </div></div><fieldset id="field_3_34" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical ll_radio ll_gfield_type_radio " data-field-class="ll_radio ll_gfield_type_radio"><legend class='gfield_label gform-field-label'><span class='gform-field-label__text'>Preferred Location</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_34'> <div class='gchoice gchoice_3_34_0'> <input class='gfield-choice-input' name='input_34' type='radio' value='Northside' id='choice_3_34_0' onchange='gformToggleRadioOther( this )' /> <label for='choice_3_34_0' id='label_3_34_0' class='gform-field-label gform-field-label--type-inline'>Northside</label> </div> <div class='gchoice gchoice_3_34_1'> <input class='gfield-choice-input' name='input_34' type='radio' value='Johns Creek' id='choice_3_34_1' onchange='gformToggleRadioOther( this )' /> <label for='choice_3_34_1' id='label_3_34_1' class='gform-field-label gform-field-label--type-inline'>Johns Creek</label> </div> <div class='gchoice gchoice_3_34_2'> <input class='gfield-choice-input' name='input_34' type='radio' value='Buckhead' id='choice_3_34_2' onchange='gformToggleRadioOther( this )' /> <label for='choice_3_34_2' id='label_3_34_2' class='gform-field-label gform-field-label--type-inline'>Buckhead</label> </div> <div class='gchoice gchoice_3_34_3'> <input class='gfield-choice-input' name='input_34' type='radio' value='Westside' id='choice_3_34_3' onchange='gformToggleRadioOther( this )' /> <label for='choice_3_34_3' id='label_3_34_3' class='gform-field-label gform-field-label--type-inline'>Westside</label> </div></div></div></fieldset><div id="field_3_36" class="gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_select ll_gfield_type_select " data-field-class="ll_select ll_gfield_type_select"><label class='gfield_label gform-field-label' for='input_3_36'><span class='gform-field-label__text'>Treatment of Interest (Plastic Surgery)</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_36' id='input_3_36' class='large gfield_select' aria-required="true" aria-invalid="false"><option value=''>Choose one.</option><option value='Face Surgery'>Face Surgery</option><option value='Breast Surgery'>Breast Surgery</option><option value='Body Surgery'>Body Surgery</option>
753<option value='Liposuction'>Liposuction</option><option value='Injectables'>Injectables</option></select><svg class="pointer-events-none fill-current icon icon-chevron-down select-dropdown-arrow"><use xlink:href="#icon-chevron-down"></use></svg></div></div><div id="field_3_38" class="gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_select ll_gfield_type_select " data-field-class="ll_select ll_gfield_type_select"><label class='gfield_label gform-field-label' for='input_3_38'><span class='gform-field-label__text'>Treatment of Interest (Beauté)</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_38' id='input_3_38' class='large gfield_select' aria-required="true" aria-invalid="false"><option value=''>Choose one.</option><option value='Injectables'>Injectables</option><option value='Laser Treatments'>Laser Treatments</option><option value='Microneedling'>Microneedling</option><option value='Facials'>Facials</option><option value='Peels'>Peels</option><option value='Body Contouring'>Body Contouring</option><option value='Medical Weight Loss'>Medical Weight Loss</option><option value='Hormone Optimization'>Hormone Optimization</option><option value='Vaginal Rejuvenation'>Vaginal Rejuvenation</option><option value='Comprehensive Wellness'>Comprehensive Wellness</option><option value='IV Therapy'>IV Therapy</option><option value='Peptide Treatments'>Peptide Treatments</option><option value='Hair Restoration'>Hair Restoration</option></select><svg class="pointer-events-none fill-current icon icon-chevron-down select-dropdown-arrow"><use xlink:href="#icon-chevron-down"></use></svg></div></div><fieldset id="field_3_13" class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden gfield--choice-align-vertical ll_checkbox ll_gfield_type_checkbox " data-field-class="ll_checkbox ll_gfield_type_checkbox"><legend class='gfield_label gform-field-label gfield_label_before_complex'><span class='gform-field-label__text'>What type of service(s) are you interested in?</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_3_13'><div class='gchoice gchoice_3_13_1'> <input class='gfield-choice-input' name='input_13.1' type='checkbox' value='Plastic Surgery' id='choice_3_13_1' /> <label for='choice_3_13_1' id='label_3_13_1' class='gform-field-label gform-field-label--type-inline'><svg class='fill-current icon icon-checkbox'><use xlink:href='#icon-checkbox'></use></svg><svg class='fill-current icon icon-checkbox-checked'><use xlink:href='#icon-checkbox-checked'></use></svg>Plastic Surgery</label> </div><div class='gchoice gchoice_3_13_2'> <input class='gfield-choice-input' name='input_13.2' type='checkbox' value='Aesthetic' id='choice_3_13_2' /> <label for='choice_3_13_2' id='label_3_13_2' class='gform-field-label gform-field-label--type-inline'><svg class='fill-current icon icon-checkbox'><use xlink:href='#icon-checkbox'></use></svg><svg class='fill-current icon icon-checkbox-checked'><use xlink:href='#icon-checkbox-checked'></use></svg>Aesthetic</label> </div><div class='gchoice gchoice_3_13_3'> <input class='gfield-choice-input' name='input_13.3' type='checkbox' value='Wellness' id='choice_3_13_3' /> <label for='choice_3_13_3' id='label_3_13_3' class='gform-field-label gform-field-label--type-inline'><svg class='fill-current icon icon-checkbox'><use xlink:href='#icon-checkbox'></use></svg><svg class='fill-current icon icon-checkbox-checked'><use xlink:href='#icon-checkbox-checked'></use></svg>Wellness</label> </div></div></div></fieldset>
753<div id="field_3_39" class="gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_select ll_gfield_type_select " data-field-class="ll_select ll_gfield_type_select"><label class='gfield_label gform-field-label' for='input_3_39'><span class='gform-field-label__text'>How did you hear about us?</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_select'><select name='input_39' id='input_3_39' class='large gfield_select' aria-required="true" aria-invalid="false"><option value='Social Media (Instagram, Facebook, TikTok, etc.)'>Social Media (Instagram, Facebook, TikTok, etc.)</option><option value='Newsletter'>Newsletter</option><option value='SMS'>SMS</option><option value='A Friend or Family Member'>A Friend or Family Member</option><option value='Doctor Referral'>Doctor Referral</option><option value='Walk-In / Drove By'>Walk-In / Drove By</option><option value='Google'>Google</option><option value='Other'>Other</option></select><svg class="pointer-events-none fill-current icon icon-chevron-down select-dropdown-arrow"><use xlink:href="#icon-chevron-down"></use></svg></div></div><div id="field_3_40" class="gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_text ll_gfield_type_text " data-field-class="ll_text ll_gfield_type_text"><label class='gfield_label gform-field-label' for='input_3_40'><span class='gform-field-label__text'>Other</span><span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_40' id='input_3_40' type='text' value='' class='large' aria-required="true" aria-invalid="false" /></div></div><div id="field_3_31" class="gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_text ll_gfield_type_text " data-field-class="ll_text ll_gfield_type_text"><label class='gfield_label gform-field-label' for='input_3_31'><span class='gform-field-label__text'>Message (Optional)</span></label><div class='ginput_container ginput_container_text'><input name='input_31' id='input_3_31' type='text' value='' class='large' aria-invalid="false" /></div></div><div id="field_3_30" class="gfield gfield--type-gfsi_sources gfield--input-type-gfsi_sources gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_gfsi_sources ll_gfield_type_gfsi_sources " data-field-class="ll_gfsi_sources ll_gfield_type_gfsi_sources"><input type="hidden" name="input_30" class="gfsi_source gform_hidden" id="input_30_3" value="direct" /></div><div id="field_3_35" class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible ll_html ll_gfield_type_html " data-field-class="ll_html ll_gfield_type_html"><p style="font-size: 10px;">By providing my mobile number and clicking Submit, I consent to receive recurring automated marketing and professional text messages from Artisan Plastic Surgery at the number provided. Message frequency may vary and message & data rates may apply. Reply STOP to cancel or HELP for help. Consent is not a condition of purchase.</p></div></div></div> <div class='gform-footer gform_footer top_label'> <button class='button btn-primary ll-submit' id='gform_submit_button_3' type='submit'>Submit</button> <input type='hidden' name='gform_ajax' value='form_id=3&amp;title=&amp;description=&amp;tabindex=0&amp;theme=gravity-theme&amp;styles=[]&amp;hash=efa939ded8c80bda9c3a8d4a66c8d7fe' /> <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_3' value='iframe' /> <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_3' id='gform_theme_3' value='gravity-theme' /> <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_3' id='gform_style_settings_3' value='[]' /> <input type='hidden' class='gform_hidden' name='is_submit_3' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='3' /> <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='vne7533A0sTQasnFTlE1CAB6lNuhx
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