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SUBMIT PAYMENT

GYN and GEN SURGEON – COMPLETE ONLINE or PRINT & SEND

Select any of the following forms to complete.

GYN Physician (online form or download form)
GYN Center of Excellence (online form or download form)
General Surgery Physician (online form or download form)
General Surgery Center of Excellence (online form or download form)
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    Accepted file types: pdf, jpg.

BARIATRICS (SPANISH) – PRINT & SEND

BARIATRICS Physician SPANISH (print)
BARIATRICS Center of Excellence SPANISH (print)

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BARIATRICS (PORTUGUESE) – PRINT & SEND

BARIATRICS Physician PORTUGUESE (print)
BARIATRICS Center of Excellence PORTUGUESE (print)

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    Accepted file types: pdf, jpg.

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