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FCC Consent to Fax & Email

On August 18, 2003, the FCC issued an order delaying the implementation of this law until January 1, 2005.

The Georgia Orthopaedic Society remains interested in receiving your permission as this law may still be implemented. We encourage you to continue the log in process and we thank you for your assistance.

NAME:
MY CURRENT FAX NUMBER IS:
MY CURRENT EMAIL IS:

I am authorized to and hereby consent to receiving information from the Georgia Orthopaedic Society via fax and/or email about Georgia Orthopaedic Society products, programs, and services. I understand that this information will be sent by or on behalf of the the Georgia Orthopaedic Society (GOS).

AUTHORIZED SIGNATURE
DATE

OR If you do not give Georgia Orthopaedic Society permission to contact you about products, programs, and services,
select here: