You should book the consult when your ready to move forward with a surgery. You should already be in Orthodontics, and have submitted molds of your teeth, medical records (bite impressions, Xrays, Cephs, Pano, professional photos of your teeth from isometric views, sleep studies if applicable to airway issues, questions you may have or your Ortho wants to know). You should commit to have this done, have a orthodontic plan in place so he can work with him/her in final placement of the teeth. So if you plan early, I could possibly see another consult because the way the teeth move in relation to the jaw placements. Your correct he does not do (to my knowledge and based on What Kim told me) any virtual consultations or phone consults, he needs a physical model in front of him, and it's worth it. It's a 2 hour comprehensive evaluation in office, he will give you detailed plans on what needs to be done, answering your questions, working out a plan with any insurance company to cover hospital fees. I've yet to read even 1 review online that gave him any negative reviews, and you get what you pay for here. He is skilled in revision jaw surgeries and I'm fairly impressed with seeing the results of his patients I've talked to online.