| |  |  | | The doctors of the Urology Institute and Impotence Center of Dallas now offer online consultation. There are three levels of service: Level 1, our standard service, for a charge of $100, Level 2, extensive service, for a charge of $150, and Level 3, our most complex/comprehensive service, for a charge of $200. Simply complete the form below, and one of our doctors will gladly assist you.
- Standard service - $100
- Extensive service - $150
- Complex/comprehensive service - $200
|  |  | | We are now secure!! For your convenience, we have now added secure transactions to our web site. | | |  |  | | Please complete all fields in the form below. We will not be able to process your request without complete information. |  |  | | Name: |  |  | | Address: |  |  | | City: |  |  | | Email: |  |  | | Expiration date: |  |  | | Please use the box below to carefully describe your problems or concerns. A member of our staff will assist you shortly. | |