Joint Replacement PreOperative Class
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Surgeon
*
Procedure/Surgery
*
Date of Procedure/Surgery
-
Month
-
Day
Year
Date
Please select on which day you would like to attend:
*
Please Select
August 22, 2024
August 29, 2024
September 5, 2024
September 9, 2024
September 16, 2024
September 23, 2024
September 26, 2024
Would you like to join us virtually or in-person?
*
Please Select
Virtual
In-person (Queen Emma Tower, 8th Floor, Ewa Conference Room)
If you are unable to attend class during one of the scheduled dates and times, would you like a pre-recorded class video?
*
Yes, I would like a recording of a past class
No
Submit
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