Book your consultation with doctor Bart

Would you like advice from doctor Bart about your nose and to schedule an appointment? Please submit your details and the requested photos via the form below.

After reviewing your application, doctor Bart will invite you for a consultation. During this appointment, your wishes will be discussed and the expected result will be evaluated using photo simulation.

The current waiting time for a consultation is approximately 2 months.
You will receive a response within 10 days (please check your spam folder).
Before & after results can be found on Instagram: @dr_bartclinic.
We treat your personal data with the utmost confidentiality.
On instagram you can already see the noses operated by me as an example of my style! @dr_bartclinic.
It goes without saying that your data will be treated completely confidentially.

Contact information

First name

Family name

Mail address

Phone number

Date of birth

Residence

Geslacht

General information

Have you had surgery before? Please specify.

Do you use medication?

What is your overall health?

Length (cm)

Weight (kg)

What do you expect to achieve?

Which procedure did you have in mind?

Photo upload

Instructions

Photos without makeup. Hair pulled back neatly.
With a completely relaxed face, looking straight ahead.
The whole face including the ears and neck up to the collarbones should be visible.

Note: Maximum 3 MB per photo!

Operation report upload

If you have had surgery on your nose before, please enclose the operation report.

Bedankt voor uw aanvraag

Wij nemen zo spoedig mogelijk contact met u op.