Home
Forms
Tell A Friend
Contact Us
Newsletter
Meet the Physicians and
the Staff
at Sun Coast »
About Obesity
Adjustable Gastric Band
Amssss I A Candidate?
Our Process
Calendar
FAQ
Latest News
About Obesity link 01
About Obesity Link 02
Lap Band
Realize Band
Self-Pay (BMI 30-35)
About Obesity link 01
About Obesity Link 02
Forms
Forms
Forms
Newsletter
Register To Attend A Free Seminar
Sign up today to attend a free seminar!
Seminar Details
Date and Time of Seminar
February 6, 2012, 6:00 PM - 8:00 PM
February 13, 2012, 6:00 PM - 8:00 PM
February 20, 2012, 6:00 PM - 8:00 PM
February 23, 2012, 6:00 PM - 8:00 PM
February 25, 2012, 10:00 AM - 12:00 PM
March 1, 2012, 6:00 PM - 8:00 PM
March 15, 2012, 6:00 PM - 8:00 PM
March 20, 2012, 6:00 PM - 8:00 PM
April 5, 2012, 6:00 PM - 8:00 PM
April 26, 2012, 6:00 PM - 8:00 PM
May 3, 2012, 6:00 PM - 8:00 PM
May 17, 2012, 6:00 PM - 8:00 PM
June 7, 2012, 6:00 PM - 8:00 PM
June 21, 2012, 6:00 PM - 8:00 PM
July 19, 2012, 6:00 PM - 8:00 PM
July 31, 2012, 6:00 PM - 8:00 PM
August 11, 2012, 6:00 PM - 8:00 PM
August 11, 2012, 6:00 PM - 8:00 PM
August 16, 2012, 6:00 PM - 8:00 PM
August 25, 2012, 10:00 AM - 12:00 PM
August 30, 2012, 6:00 PM - 8:00 PM
September 8, 2012, 10:00 AM - 12:00 PM
September 20, 2012, 6:00 PM - 8:00 PM
September 27, 2012, 6:00 PM - 8:00 PM
October 13, 2012, 10:00 AM - 12:00 PM
October 18, 2012, 6:00 PM - 8:00 PM
October 30, 2012, 6:00 PM - 8:00 PM
November 1, 2012, 6:00 PM - 8:00 PM
November 15, 2012, 6:00 PM - 8:00 PM
December 6, 2012, 6:00 PM - 8:00 PM
December 20, 2012, 6:00 PM - 8:00 PM
Title:
Largo - Adjustable Gastric Band Info Session
Where:
Hampton Inn - 100 East Bay Drive, Largo FL
REGISTER NOW
Patient Information
Date of Birth
*
- month -
January
February
March
April
May
June
July
August
September
October
November
December
- day -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
- year -
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Height
*
feet
inches
Weight
*
pounds
First Name
*
Last Name
*
Gender
*
-- select a gender --
Male
Female
Contact Information
Address 1
*
Address 2
City
*
State
*
-- select a state --
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
*
Country
United States of America
Primary Phone
*
Alternate Phone
E-mail Address
*
Others
Insurance
Excluding yourself, how many guests will you bring?
*
---
0
1
2
3
4
How did you hear about us?
*
Related Topics
Register for a Seminar