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Open House - Injection Day

Injection Day Order Form

HOW TO ORDER:

Complete the Injection Day Order Form
Calculate your total amount due
Complete the credit card authorization form
Email completed forms (pages 1, 2 & 3 ) to [email protected]

Sugene Kim, MD

Plastic Surgeon

Schedule Consultation

By completing this form, you are giving us permission to follow-up by phone, email or text.*

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