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Weight Loss Surgery Center

Information & Forms

Below are important PDF documents talked about on this web site. Click to download, view and print.

Introductory Forms

  • Patient Workbook
  • Weight Loss Surgery Questionnaire


Surgery Preparation

  • Preoperative Requirements*
  • Preoperative Laboratory Request
  • Final Preoperative Instructions
  • Adjustable Band Bowel Preparation
  • Gastric Bypass and DS Bowel Preparation


Insurance Information

  • Understanding Your Insurance Coverage

Consultation Requests

  • Cardiology Clearance Letter*
  • Primary Care Provider Letter*
  • Pulmonary Clearance Letter*
  • Psychology Evaluation Request Letter*

Dietary Guidebook

  • Laparoscopic Gastric Bypass
  • Laparoscopic Adjustable Band
  • Laparoscopic Duodenal Switch
  • Dr. Buchwald Gastric Bypass/VBG

Additional Dietary Resources

  • Food Log
  • Grocery List
  • Protein Sources
  • Post Gastric Bypass Hypoglycemia Diet

Postoperative Forms

  • Annual Lab Tests
  • Band Assessment Clinic Form
  • Return Bariatric Surgery Form

General Surgery - (Non-Bariatric)

  • General Surgery Questionnaire

*Documents marked with an asterisk are also found in the Patient Workbook
 

Related Links


    • Weight Loss Surgery Clinic Home
    • About This Clinic
    • Clinical Services
    • Meet Our Team
    • Patient Information
    • Related Links
    • Frequently Asked Questions (FAQs)
    • Step by Step Guide
    • BMI Calculator
    • Information & Forms
    • FMLA Paperwork


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