Dr. Ponce

Call us at:
[619] 754.4962

Fills Print E-mail

 

Do you need a fill?

If you have not loss the weight you want, you might need a fill. A fill helps adjust the band to restrict your eating to about a third of your normal intake.

Please fill the form with your information to schedule a lap band fill at Realize 4 Me Center.

 

 

Please, provide the following information so we can provide you a better service.

When filling this form you will be contacted by one of our representatives and confirmed your appointment.

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Name:*
mobile telephone:* home telephone:
e-mail:*   
alternative e-mail:*   
Date for the fill:
arrival date:
arrival time:
:hrs
  
airline:flight number:
Who is your patient coordinator :
Comments:*
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Just a few suggestions:

Our courtesy vehicle depends on availability, and there might be a waiting time. For this reason we advice you to please schedule a fill one week ahead, and arrange your arrival and departure flights with enough in between time. (8hrs. recommended).

Although the fill procedure only takes approximately 45 minutes, you have to take on account traffic (especially on weekends), and doctor waiting time. Remember that you may not be the only one scheduled for a particular date.

 

 
 
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