Please fill out the following form before your consultation appointment with Dr. Diktaban. You may print out and bring the forms with you. However, our office prefers you fill out digitally and email to OfficeManager@drdiktaban.com.
Theodore Diktaban, MD, FACS
Double Board-Certified Plastic Surgeon
For over 35 years, Theodore Diktaban, MD, FACS, has made it his life's work to enhance the natural beauty of his patients in the Upper East Side and surrounding areas of New York City. As a double board-certified plastic surgeon, Dr. Diktaban provides the ideal blend of realistic, aesthetic, and safe cosmetic treatments and procedures.