All fields in red are mandatory:

Offer is ONLY good between Feb. 5th and Feb. 10th. Fill in your appointment request below.

* First Name:

* Last Name:

* Email Address:

* Cellphone (include area code, no dashes):

For appointment reminders and offers. msg & data rates may apply. To cancel, text STOP.

*
At Which Office Would You Like To Be Seen:

* Appointment Date Requested:

* Appointment Time Requested (e.g. 1:00 pm)
Please write in the space below the time you would like to be seen at our office (e.g. 1:30 pm).

* Appointment Type:


If you are a returning patient, when was your last visit to our office?:
(please enter the month and year below)


(e.g Jane Smith - coworker)

Questions & Comments:

Success Stories

"My weight loss journey began on Wednesday, June 16th. This is the day I made a decision to face my weight issues once and for all. I was blessed to be introduced to Dr. Jon Fisher of Fisher’s Medical Weight Loss Centers.
As of June 30th, I have lost 11.4 pounds! I’m eating better, I feel better and I’m sleeping better. I have tried many diets before but this one is not a diet, it’s a lifestyle change program for me. It’s safe and effective.

Cece McGhee
WPPZ-PRAISE 103.9FM
Praise 103.9's Afternoon Angel

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Success Stories

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