Find out how the local surgeons in your area work by contacting one or two if you have more then one, check this site it will tell you who they are.... then check with your insurance in my case my first appt wasn't billed to the insurance co it was a flat fee and then if I was sure we moved fwd. then after I made a decision I needed a referral from my pcp and then moved fwd with my surgeon. check with the docs office first I didn't have to go to any seminar just a few support group meetings. Good Luck