Book a Cosmetic Consultation Please enable JavaScript in your browser to complete this form.The Cosmetic Consutlation Request is only for cosmetic concerns. If you have a medical concern please have your family physician send over a referral via fax to 780.428.5556 and our office will give you a call to book in. If you are an existing patient of Stratica Dermatology, please give our office a call at 780.428.5554 to book in. We look forward to welcoming you in clinic!What would you like a consultation for?Services & Products---Botox/DysportDermal FillerWrinkle Treatment PRP for Hair LossPRP for Facial RejuvenationMesotherapyMicroneedlingSkin CareVbeam PulseDye LaserC02RE Resurfacing LaserZO Stimulator peelConcerns---Acne Prone SkinAcneAgingHair Loss Hyperpigmentation (Uneven Skintone)WrinklesScaringVolume Loss First Name *Last Name *Date of Birth *MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Phone Number *Email *Requesting a consultation with *---Trish ManalacDr. Mariah GibersonDr. Andrew FerrierDr. Aisha MirzaDr. Lana WicentovichFirst AvailableRequesting a consultation with *---Trish ManalacRebecca Hauck First AvailableRequesting a consultation with *---Trish ManalacRebecca Hauck Karie SchnellChristina AtamanikLerah PalmaIngrid ListonFirst AvailableRequesting a consultation with *---Rebecca Hauck Karie SchnellFirst AvailableRequesting a consultation with *---Rebecca Hauck Karie SchnellDr. GibersonDr. FerrierFirst AvailableBook Now
