Close
In this section
Back
Main Menu
Find A Doctor
Find a Service or Speciality
Patients & Visitors
Careers
Contact Us
Patient Portal
Careers
Contact Us
Patient Portal
Find A Doctor
Find a Service or Speciality
Patients & Visitors
search
show off canvas menu
Home
HCHS
Services
CoolSculpting
Am I a Candidate
Am I a Candidate
*
Asterisk indicates a required field.
First Name
*
Last Name
*
Email Address
*
Phone
*
I'm tired of getting minimal results from my diet and exercise efforts
*
Yes
No
I'm no longer as confident in my body as I once was
*
Yes
No
I would feel better about myself if I lost fat around my stomach or love handles
*
Yes
No
I'm interested in a lasting, safe and effective treatment that is non-invasive
*
Yes
No
I'm within 5-35 pounds of a healthy and ideal weight for my height
*
Yes
No
How did you hear about CoolSculpting at HCHS?
*
Friend
Facebook
Googled: Bodify
Googled CoolSculpting
Newspaper
Radio
TV
Other
If Other, please specify:
I agree to Terms and Conditions
