Thanks for the additional feedback.
So to summarize, I'll ask Patrick to trim the waist by about 2" (I'll actually see how much excess fabric I have at the waist and judge from that), raise the collar by about 1/2" (though I do have my chin up in the photo), lengthen the sleeves by about 1", trim the sleeves, and raise the armholes.
The shirt is not tight around my chest, but I suspect that BjornH and Luc-Emmanuel are right that my shoulders are back more than normal. Because I usually slouch forward, I sometimes try to compensate by keeping my shoulders back. However, I notice some puckering across the chest whenever I wear the shirt, so some of the effect appears when I'm standing naturally. I'm not sure how to communicate this to Patrick, other than trying my best to forget about posture when modeling the shirt. This will be hard to do, since I'm working with an osteopath to correct some postural issues and I'm very conscious of my posture. In an ideal world, I wouldn't be buying shirts and a suit right now, but I can't walk around naked.
Get Smart, Chan charges $110 per shirt and they do the measurements. I don't expect a perfect product on the first try, but I would like the second and subsequent shirts to be much better. I've tried the self-measuring route and the results were not as good. I should also say that this is not a fair representation of Chan's work, for reasons given in the paragraph above. They really are shooting at something of a moving target, as my posture has improved somewhat in the past 9-10 months.