Welcome to Liposuction 101
In the OR, Hands-On Tumescent Liposuction Course
Approved for up to 27 hours of CME by University of California, Irvine School of Medicine

Enrollment Instructions

Instructions for Surgeons: The following items are required for enrollment.

1. Signed Enrollment Application Form. You may obtain a copy of Enrollment Application Form either by downloading then printing the form, or by contacting us to request that we fax or mail you the form. Contact us by: Tel: (949) 248-1632 | Fax: (949)-248-9339.
   
2. In addition the following items should be faxed or mailed to us.
   Your Curriculum Vitae
   Copy of liability insurance (malpractice coverage)
   Copy of medical license
   1 letter of recommendation from a physician colleague providing specific information about your professional ethics and surgical skills.
   Signed Confidentiality Agreement
   Signed Disclaimer Agreement
   
3. $1,800 Deposit: Due with application. This may be paid either by
   credit card via telephone (949-248-1632 or by
   mailing a check 30280 Rancho Viejo Road, San Juan Capistrano, CA 92675.
   $5,000 Balance is due 6 weeks prior to the first day of the course.
   
4. Required Text Book: Tumescent Technique, by Jeffrey Klein, Mosby, 2000. All Doctors will receive a copy once they arrive for the course. To view an online html version of the book, click here. Photos and illustrations found in the book, will not appear on this online version.
   
5. Contact Information: For questions or additional information, please contact:
   Atoussa Cameron, RN, FNP
   Course Coordinator
   Email: atoussa@jeffreykleinmd.com
   Tel: (949) 248-1632, ext. 210
   Fax: (949) 248-9339

Enrollment Application Form (Printable)

Confidentiality Agreement (Printable)

Nurse & Medical Assistant Application Form (Printable)