Become a Patient Ambassador

Introduction

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Enroll

To sign-up, please fill out & submit the form below:

Date
Date Format: MM slash DD slash YYYY
Name*
Number
Email
Mark opportunities you are comfortable with:
- Being a referral source for potential patients inquiring about similar procedures
- Use of before and after photos on website
- Use of before and after in-office & seminars
- Speaking about your experience at one of Dr. Thompson's seminars
- Photoshoot for website homepage with testimonial
- Online video testimonial for website & social media posts
- Testimonial and/or pictures in television commercial
- Television appearances with Dr. Thompson regarding procedure(s)
Contact [email protected] with any questions or concerns. ONLINE REVIEWS are INCREDIBLY helpful for those in the research process! Please leave your testimonial at 1 or more of the review sites listed at the page that will appear after hitting the submit button. Enter the number of reviews left at the bottom of the page to be entered in the next contest for FREE BOTOX! Each review is one entry:) Email [email protected] with any questions.
Add any criteria or limitations requested regarding this authorization:
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Don't Hesitate To Contact Us

CALL

801.776.2220

Draper Office
723 East 12200 South
Suite 200
Draper, UT 84020

Layton Office
2255 N 1700 W
Suite 205
Layton, UT 84041

Don't Hesitate To
Contact Us

CALL 801.776.2220

Draper Office

723 East 12200 South
/
Suite 200
/
Draper, UT 84020

Layton Office

2255 N 1700 W
/
Suite 205
/
Layton, UT 84041

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