tailieunhanh - THE AESTHETIC SURGERY CENTER

Another kind of reductionism occurs with attempts to reduce percep- tion to brain processes or neural events (Ramachandran & Hirstein 1999). Evidently, the brain is necessary for perceptual processing. Yet, according to TSC, perceptual processes are constructed in real time in the interaction between agent and environment. As Harth (2004) remarks in discussing the relation between neurophysiology and art, a theory of artistic expression must take into account not only the human brain, but also the world at large. A description of the brain events that occur during artistic creativity (or aesthetic experience) cannot account for the nature of. | Print Form The Aesthetic Surgery Center Date Name 1. How did you hear about The Aesthetic Surgery Center The Face Spa Dr. Richard Maloney and or Dr. Anurag Agarwal select all that apply QI Attended a Seminar Q Word of Mouth Q Positive Aging Television Show Q Take A Look Television Show Q Visted Q Referral by a freind Q Other - Please specifiy 2. Have you seen any of our advertisements select all that apply Q N Magazine Q Gulfshore Life Q Naples Yellow Page Directory Q Naples Daily News Q Ft. Myers News Press Q Ft. Myers Yellow Page Directory 3. What reason s were most important in your decision to make an appointment select all that apply Q Dr. Maloney s Dr. Agarwal s extensive experience and credentials Q The location of The Aesthetic Surgery Center Q Skin care services offered Q Skin care products offered Q Computer Imaging System Q Office staff was knowledgeable and courteous Q Pricing seemed fair and reasonable Q Referral from someone else Thank you for taking the time to complete our questionnaire RICHARD W. MALONEY . . ANURAG AGARWAL . . THE PHYSICIANS BUILDING SUITE 1115 11181 HEALTH PARK BLVD NAPLES FLORIDA 34110 The Aesthetic Surgery Center Welcome to Our Office Date PLEASE PRINT Last Name First Name Middle Address Email Address OUT OF TOWN ADDRESS City State Zip Code Address City State Zip Phone Number How did you hear about Dr. Maloney or Dr. Agarwal Did you attend one of our Seminars YES I NO I I QI Female Social Security last 4 Date of Birth Height Weight Age Martial Status check one Sex Q Male Home Phone Cell Phone SING MAR WID DIV SEP Employer Employer s Address Business Phone Spouse s Name Occupation Business Phone Primary Insurance Company Secondary Insurance Company Policy Holder Policy Holder s Date of Birth Policy Holder s SSN Next of Kin Relation to the Patient Phone Number Which surgical procedures are you interested in check all that apply .

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