Patient Area - Re-Entry Application

To apply to our Weight Loss program as a Re-entry patient (previously participated in Weight Loss), download below:

(Acrobat Reader is required to view these files: click here for the free download.)

Once downloaded, you can fill out your application on a computer (click here for instructions), or you can print and complete your application by hand.

Please return your application by email to info@keepitoff.com or by fax to our Sacramento office at 916-978-0333.

Please contact us if you have questions.

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