Michael Moore - Sonata Treatment

I am voluntarily providing the information requested in this survey, including my personal and health information. I understand that Gynesonics will use my personal and health information to help me identify a physician who may be able to treat my medical condition. I understand that once I provide such information it will be shared with Gynesonics representatives and physician offices and may be used to contact me for follow up communications including via phone, email or text messages.

Michael Moore, MD

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