Request An Appointment

Bluewater Plastic Surgery

Choose a Location

Niceville

4550 East Hwy 20, Ste L, Niceville, FL 32578

Miramar Beach

6757 US-98, Suite 302, Miramar Beach, FL 32550

Choose a Provider

First Available

Steven Clark, M.D., D.M.D., FACS

Michelle Sasala, ARNP-BC

Patient Details

Patient First Name

Patient Last Name

Phone

Date of Birth

Reason For Request

Additional Details

Preferred Days of the Week

Please select at least one day

Any Time

Morning

Mid Morning

Afternoon

Late Afternoon

Evening

No Urgency

Same Day

Within 48 hours

This week

I'm flexible

Select Referral Source

Search(Google, Bing, etc)

Social Media

Referral

Word of Mouth

Friends / Family

Online Advertisement

Television

Radio

Other

Sky Advertisement

I accept the Privacy Policy and Terms of Use.

I would like to receive text communications from Bluewater Plastic Surgery via Treatspace, such as appointment confirmations, appointment reminders, and feedback requests. Message & Data rates may apply.

If you have an emergency, Call 911

Experiencing Issues With This Form? Contact Support

Request An Appointment

Patient Details

Additional Details

You Appointment Request Has Been Received!

Your Request Summary