Do you need help finding a plastic surgeon?
Start by filling out the questionnaire and then book your call!
Big Butts No Lies Questionnaire
Thank you for trusting me with your surgery journey. The answers to these questions will help me evaluate if you are a good candidate for the membership. Once your questionnaire is received, I will call you. I am so excited for the new you!
Full Name
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Email
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Phone
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Date of birth
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Address
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City
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State
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How did you hear about Mavi or BIG BUTTS NO LIES PODCAST?
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What procedures are you interested in?
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MOMMY MAKEOVER
LIPO/BBL
BREAST LIFT
BREAST AUGMENTATION
BREAST REDUCTION
TUMMY TUCK
FACE/NECK LIFT
RHINOPLASTY
THIGH LIFT
BRACHIOPLASTY
BUCCAL FAT
BRACHIOPLASTY
BUCCAL FAT
SKINCARE ASSESMENT
FILLER/BOTOX
EXPLANT
Where are you in the process?
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Just started thinking about it
Need help finding a surgeon
Booked and researching post op
Need help with losing weight
Need guidance with FAJA and lymphatic massages
Analysis Paralysis
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Are you at your goal weight?
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YES
NO
I'm working on it
I don't know if I need to lose/gain weight for surgery
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What is your current weight and height?
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Have you had any consultations?
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Yes
No
Scheduled
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What is your budget? It is important to understand that excellent quality plastic surgery is expensive and not financially attainable for everyone. I do my best to match you with excellent quality surgeons. I can also help you apply for financing if you would like assistance.
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5-10k
10-15k
15-20k
20-30k
35-50k
50k+ for the right doctor
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Do you need help with financing?
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Yes
No
Are you willing to travel? Every country has their TOP plastic surgeons. Finding the best plastic surgeon for your goals might
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yes
no
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Where are you willing to travel?
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within my state
within the USA
Mexico
Dominican Republic
Colombia
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Do you need help with post op care?
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Nope, I already listened to the podcast
Yes, I need all the help
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Do you prefer a female or male surgeon
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Male
Female
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Do you have support at home?
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Yes
No
I will need assistance with home health nurse
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What do you need help with? Your answer here helps me serve you better.
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Do you want to receive before and afters pictures from my favorite doctors?
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YES!
Not really.
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The membership is a monthly fee of $75. With the $75 you'll have one on one access to me during your journey. Anything you need, I'm only a text or phone call away. I can guide you with any part of your journey. Finding a surgeon, preparing your body, recovery and supplies as well as MAINTANCE. You can cancel ANYTIME.
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The membership isn't for me.
I want you to coach me !
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HIPPA Acknowledgement: Please be aware that this is a secure email network under HIPPA guidelines. Do not submit any personal or private information unless you are authorized and have voluntarily consented to do so. We are not liable for any HIPPA violations. Understand that if you submit this form, you are agreeing to the use of this secure method and understand that all replies will be sent by standard (unsecured) email, which you are hereby authorizing. By checking this box you hereby agree to hold BIG BUTTS NO LIES/ Mavi Rodriguez - including doctors and affiliates, harmless from any hacking or any other unauthorized use of your personal information by outside parties.
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By checking this box, I acknowledge my understanding of the HIPPA Policy and agree with its contents.
