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Patient Sign Up Form

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By clicking "SUBMIT" I understand that I will be taking medication for the sole purpose of losing weight. If I experience adverse side effects I will stop the medication and call the doctor’s office. I will, under no circumstances, transfer, sell, or give this medication to any other person. For directions and more information about possible side effects, please read our new Georgia Bariatrics Patient Handbook available on the website.
Somebody will contact you within 48 hours to establish you as a registered patient.