Don't Forget To Read Our Insider's Guide Click Here to get the Insider's Guide The 26 Questions You Need To Ask Before Having Surgery In Mexico Click Here to see the 26 Questions Plastic Surgery Quote & Contact Form Here you can request someone to contact you and also request an accurate quote. Name* First Last Email* Enter Email Confirm Email Phone*Age*Sex*MaleFemaleWould you like to request a quote?*YesNoWould you like to request a quote on one of our procedures?Additional Required InformationAdditional information required to accurately calculate your quote.Height (inches)*List your height in inches. (12 inches = 1ft.)Weight (lbs)*BMI*Body Mass IndexHeight (m)*Weight (kg)*Height (squared)*Do you have any cardiac issues?*YesNoHave you in the past, or currently have cardiac issues?If yes, can you get a Cardiac clearance letter from your Doctor?*YesNoHave you recently had weight loss surgery?*YesNoHave you recently had any weight loss surgeries that need a revision?Weight Loss Procedures*Gastric SleevePlicationMini Gastric BypassFull Gastric BypassWeight Loss Revision Procedures*Gastric Sleeve RevisionBand to SleeveGastric Bypass RevisionRevisions or repairs to prior proceduresDo you currently smoke?*YesNoDo you currently smoke cigarettes or cigars?Do you currently have symptoms of Heart Burn and/or Acid Reflux?*YesNoWARNING!You must stop smoking 2 weeks prior to surgery up until 4 weeks after the surgery.WARNING!An additional cost of $500 is a hernia is discovered.Are you currently prescribed any pain medications?*YesNoDo you currently use a CPAP Machine?*YesNoWARNING!You must bring your own pain medication for your surgery.WARNING!You must bring your own CPAP machine or there will be an extra charge.Have you been diagnosed with/or do you have a Hiatal Hernia?*YesNoHernia Repair Price: $500.00 Do you wish to have your Gall Bladder removed?YesNoBladder Removal Price: $500.00 Total $0.00 NameThis field is for validation purposes and should be left unchanged.