Appointment Request

Whether your goal is to achieve a more youthful appearance or to improve your quality of life, our highly skilled doctors can help you achieve your personal goals. We are committed to providing outstanding patient  care which includes the comprehensive patient services of education, consultation, treatment and follow-up care.

If you have an eyelid, orbital, or lacrimal (tear duct) problem, please contact either our Encino or Westlake Village oculoplastic cosmetic & reconstructive surgery office if you have any questions or would like to schedule an appointment. You may also use our appointment request form below to schedule your appointment. Our scheduling coordinator will contact you to confirm your appointment.

Please do not use this form to cancel or change an existing appointment.

*Items in bold are required.
Are you a current patient?

Which office location(s) would you prefer for your appointment?

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

Preferred time(s) for an appointment?

Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.


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Office Location

  • Encino
  • 5363 Balboa Blvd.
  • Suite 246
  • Encino, CA
  • 91316
  • Map & Directions
  • Call: (818) 783-3510