Benvindo a Liposuccao 101

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
   Two letters of recommendation from physicians providing specific information about your professional ethics and surgical skills.
   Signed Confidentiality Agreement
   Signed Disclaimer Agreement
   
3. Deposit: This may be paid either by
   credit card via telephone (949) 248-1632 or by
   mailing a check 30280 Ranch Viejo Road, San Juan Capistrano, CA 92675.
   The Balance is due 6 weeks prior to the first day of the course.
   
4. Required Text Book: Tumescent Technique, by Jeffrey Klein, Mosby, 2000, should be read before arriving in San Juan Capistrano for the course. This book may be purchased by telephone at
   949-369-0101 or 800-909-0060

Enrollment Application Form (Printable)

Confidentiality Agreement (Printable)

Nurse & Medical Assistant Application Form (Printable)