REQUIREMENTS – ENROLLMENT FOR PHYSICIANS
The following items need to be faxed to
949-248-9339 or mailed to Us for enrollment:
- Completed and Signed Enrollment Application Form PDF
- Signed Confidentiality Agreement PDF
- Signed Disclaimer Agreement PDF
- Copy of your current Curriculum Vitae (CV)
- Proof of malpractice insurance coverage (copy of liability insurance policy)
- Deposit of $2,400 due with application.
This may be paid either by credit card via telephone (949-248-1632) or by mailing a check payable to:
Jeffrey Klein, M.D.
30280 Rancho Viejo Road
San Juan Capistrano, CA 92675
- $5,000 Balance is due 3 weeks prior to the course.
- Text Book: Tumescent Technique, by Jeffrey Klein, Mosby, 2000.
(Required reading prior to arriving in San Juan Capistrano for the course.)