A medically supervised weight loss program offered by Toronto weight loss coach Dr. Peter Goldfarb that is safe, reliable and effective
First Name:
Last Name:
Email:
Day Number:
Night Number:
Are you committed to losing a significant amount of weight?
Yes
No
Do you have a valid OHIP card?
Yes
No
Have you been involved in other dieting programs?
Yes
No
Do you live in the Greater Toronto Area?
Yes
No
Etobicoke Medical Centre
400 The East Mall, 2nd Floor
Etobicoke, Ontario
M9B 3Z9
Tel: (416) 621-2220
Fax: (416) 621-2357
Email:
information@optifast.ca