Home » Learn More » Educational Seminar on Back Pain » More Info

Friday, September 19, 2008 - 6:00 PM

There are 1 seat(s) remaining for this seminar.

Scottsdale
The Westin Kierland Resort & Spa
6902 E. Greenway Parkway
Scottsdale, AZ 85254

To register for this free seminar, fill out the sign up form below OR call us at 866-DOCS-LSI (866-362-7574)

Complimentary refreshments will be served.

If you bring your most recent MRI films, CD, reports or CT scans to the seminar, you will have the opportunity to meet one-on-one with a physician. Please note that x-ray films are not acceptable to determine if you are a candidate for endoscopic spine surgery.

Fields marked with * are required

Personal Information
First Name:*	Last Name:*
Street Address:*	City:*	State:*
Address 2:	Zip:*	Country:*
Contact Information
Best Phone Number to Reach You* - - Ext.	Your Time Zone:
Other Phone Number to Reach You - - Ext.	Best Time to Call:*
E-Mail:*	Confirm your E-Mail:*
Answer the Following Questions
Select your Insurance Provider*	Medicaid does not cover these procedures Select Private Company: Specify Other Insurance Type:
Select the type of Insurance	N/AHMOPPO
How did you hear about LSI?*	Which Internet Site?: Specify Other Internet Site: Which Print Ad?: Specify Other Print Ad: Who Referred You?:
Will you be bringing your MRI FILMS, CD, reports or CT scans for our doctors to review?:	YesNo
How many people will be in your party, including yourself?*