Contact Us

EmpowAR Success Plan Interest Form

Please take a few minutes to fill out this form. Once completed, our team will reach out to connect with you!

First Name *

Last Name *

Phone *

Email *

How long have you been using Aesthetic Record in your clinic? *

Please rank your clinics overall usage and comfort with using Aesthetic Record: *

Please select what your goals are from a monthly plan with Aesthetic Record. *

How long are you wanting dedicated AR support? *

Have you been contacted by an Account Success Manager previously? If yes, who?

Please provide any additional information regarding your goals and expectations for a monthly plan with Aesthetic Record. Please be as specific as possible to help us place you with the correct support! *

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Suite #200

Irving, TX 75038

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AR Marketplace

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