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Authorization for Disclosure of Medical Information Thomas W. Bach Patients Name: DOB: MD, FACS, FASM BS 7385 S Pecos Rd Las Vegas, NV 89120 OFCE: (702× 4633300 fax: (702×4410251 Address: City,
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MD FACS FASMBS stands for Medical Doctor, Fellow of the American College of Surgeons, Fellow of the American Society for Metabolic and Bariatric Surgery.
Medical doctors who are fellows of the American College of Surgeons and the American Society for Metabolic and Bariatric Surgery are required to file MD FACS FASMBS.
MD FACS FASMBS form can be filled out online or submitted via mail by providing all the required information and supporting documents.
The purpose of MD FACS FASMBS is to track the professional activities and qualifications of medical doctors who are specialized in surgery and metabolic and bariatric procedures.
Information such as current medical license, surgical experience, bariatric surgery cases, and continuing education credits must be reported on MD FACS FASMBS.
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