Dinner with The Doc – Registration Form

UNCLES JULIO’s RESTAURANT KILDEER

October 17, 2019 6:00 pm – 8:00pm

The dinner is reserved for those seeking answers to their health problems and looking to improve their health. PLEASE fill out the RSVP form below in order to reserve your seat.

You will be notified via email if you qualify to attend. Please fill out the form below.
Thank you for your interest in our Dinner with the Doc!

REGISTRATION FORM

*Offer not valid for Medicare or other Federal Aid Programs
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