Make an Appointment

In order to make an appointment, fill out the form below. A secretary will then contact you.

In case you prefer to make an appointment through the telephone, please call +55 65 3626-6022, Monday to Friday, from 8 a.m. to 6 p.m.

*(required field)

Name: *

E-mail address: *

Phone number, with area code: *

City / State:

Gender: *

Is this your first appointment with Dr Samir Kehdi? *

When was the last time?

What is the main reason for your appointment? *

Face
Mouth
Eyes
Nose
Body Shape
Breast Area
Ears
Reconstructive Surgery
Other Treatments

In case of "Other Treatments", please specify:

Your message: *

Dr Samir Kehdi