Link to the patient information form and contact information

Request a Brochure / Information Packet

Patient Information Form

We're delighted that you want to find out more about self-directed health care and
the ways in which Choice Medical Services can help you manage your medical care.

Use this form to request our latest brochure. We will send a message to the email
address you provided, with a link where you can download a PDF file of our brochure
(and in the future, our Medical Tourism Information Kit). You can then print this at home
and share it with your doctor, family and others on your medical team.

If you'd prefer to have your brochure sent by regular mail, please be sure to fill in your
name and mailing address below.

Thanks for your interest in Choice Medical Services!

Rupinder Brar
President
Choice Medical Services

 

* indicates required fields
 

*First Name:
*Last Name:
*E-Mail:
if checked be sure to fill out info below
Address:
City:
State/Prov:
Postal/Zip: