E-mail

Send Email to Physician

Pacific PureLipo
Bruce Katsura, M.D.

For Assistance, Call Us Toll Free: 866-803-1194

By submitting this form, you will be emailed (to the email account you provide below) a certificate for a Free Screening at a participating facility. Once you receive the Free Screening Certificate via email, please print it out and present it to the clinic to be redeemed. You can also call Pacific PureLipo at 866-803-1194 and mention DermaNetwork.org to schedule your Free Screening. Please note that the Certificate is not to be used in combination with other promotional discounts offered at this facility.

Please provide us with the following information and someone from this facility will contact you.
* Indicates required information.

Your Information:

* First Name:
* Last Name:
* Email:
* Home Phone:
Work Phone:
Address:
City:
State:	Zip:
How soon are you seeking treatment?

What type of treatment are you interested in?

BOTOX®
Dermal Fillers
JUVEDERM®
Laser Liposuction
Nutritional Counseling
PureLipo
Restylane®

I would like information, including announcements or special promotions.

Enter a message you would like to add in this e-mail:
( Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the physician. )