Weight Loss Surgery at Kettering Medical Center and Kettering Medical Center-Sycamore

The first step to considering bariatric surgery at Kettering Medcial Center or KMC Sycamore is to learn about the surgery and our comprehensive program by attending one of our Informational Seminars.

Information Seminars start at 7:00 pm, and are located at the Nelson Center at Kettering Medical Center, the Administrative Support Building (ASB) at KMC-Sycamore campus, or at the Holiday Inn by the Dayton Mall .

Directions To Kettering (Nelson Center is inside Kettering Hospital)
Directions To The ASB (ASB is on the KMC-Sycamore Campus)
Directions To The Holiday Inn (Dayton Mall Area)

To register, please fill out the form below or call 433-5957.

Your 2008 Registration Information:
(All Fields Required Except Your Email)
You are interested in	Undecided Lap Band Roux-en-Y (Gastric Bypass)
Date & Location You're Attending
Name (First & Last)
Address
City
State
Zip Code
Email (Optional)
Daytime Phone
Height	Feet Inches Weight lbs.
Age
How Many Will Attend This Seminar?	(counting you)
Insurer Name	Ex: Blue Cross
Have You Had Any Previous Weight Loss Surgery? Which One?	Characters Left Below

How did you hear about our program?	TV Radio Newspaper Web Mail Phone Book Family / Friends Other
All information gathered from this form will only be used by Kettering Health Network and not sold to or used by any third party.