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The Osler Society

of Greater Kansas City

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Freq Asked Questions

                                                      Osler Society Membership Form

 

 

Name:__________________________________________________________

 

Address:________________________________________________________

 

________________________________________________________________

 

Phone Numbers:__________________________________________________

 

 

E-Mail Addresses:_________________________________________________

 

 

Place of Birth:____________________________________________________

 

 

Medical School and Class Year_____________________________________­­­­

 

 

Interests:________________________________________________________

 

 

 

Comments:______________________________________________________




Questions:_______________________________________________________

 

 

 

 

 

Please return the completed form to the E-Mail address listed below

………………………………………………………………………………………………………………………………………

 

 

            Sherman M. Steinzeig, MD

            6620 W. 93rd St, Apt A, Overland Park, KS 66212

            Website: MyOslerSociety.sharepoint.com           

            E-Mail:    jaydoc52@yahoo.com
           Phone:   913 649-0355

           Fax:        913 649-7550