Corewell Health Weight Loss Clinic

Lose Weight...Find Health Weight Loss Seminar Evaluation

Thank you for viewing our seminar online and completing this evaluation. In order to be considered for an in-person consultation you will need to score 80% or higher on the quiz questions below. A member of our team will reach out directly to discuss your results and next steps.

If you have additional questions, please call 269.687.4673.

1. First Name *This question is required.

2. Last Name *This question is required.

3. Date of Birth (MM/DD/YYYY) *This question is required. This question requires a valid date format of MM/DD/YYYY.

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4. Email Address *This question is required. This question requires a valid email address.

5. Primary Home Phone *This question is required.

Corewell Health Weight Loss Clinic - Niles

Lose Weight...Find Health Weight Loss Seminar Evaluation