BRUCE M. ASCOUGH, M.D. 
Plastic and Cosmetic Surgeon
5363 Balboa Avenue  Suite 338 
Encino, California
Telephone: (818) 789-0723 
Dr. Ascough is a bona fide plastic and reconstructive surgeon. He has been performing breast implant procedures and other plastic and reconstructive surgery for more than 30 years, and has been in private practice for over 20 years. In addition to his artistic skill and years of experience, perhaps the most remarkable asset of Dr. Ascough is his sensitivity to his patient's needs. As a result, his patients describe him as a surgeon who truly cares. Dr. Ascough has a fully-accredited outpatient surgi-center, complete with up-to-date monitoring and emergency equipment.

Get a FREE CONSULTATION with Dr. Ascough! Please take a moment to complete the form below which will be forwarded to Dr. Ascough and his staff. Please note that we can only process fully completed forms. Thank you.
Which procedure or medical service are you interested in?
Title
First Name
Last Name
E-mail address
E-mail address reconfirm:
Age
Occupation
Street Address
City
Nearest Major City:
State
ZIP Code
IMPORTANT: Telephone numbers below will be verified prior to Physician Referral Request delivery to the Doctor. We will not process forms with invalid telephone numbers.
Area Code & Telephone number
Telephone number reconfirm
When is the best time for us to contact you regarding this information request?
When did you wish to have your procedure performed? Immediately   This Month   Within the next 2-3 months

You may be eligible for a substantial discount on your procedure if you pay in cash or by check. Are you able to pay for your procedure  in cash or by personal check?

 YES   NO
Do you have an active credit account at this time? YES   NO

Please enter any additional questions, comments or suggestions for us here:

If you are experiencing problems with this form please click HERE By using the USPS REFERRAL SERVICE you agree to TOS

All content ©2002 Internet Medical Group® All Rights Reserved Terms of Service