Get the free BARIATRIC HISTORY

Bay Bariatric Surgery Kevin L. August, M.D. General Surgery Laparoscopic Surgery Website: http://baybariatricsurgery.com BARIATRIC HISTORY Patient Name: PRESENT ILLNESS Date: (Requirement for Insurance

How to fill out bariatric history

How to fill out bariatric history?

1. Start by gathering relevant medical documents and records related to your bariatric surgery, such as operative reports, discharge summaries, and any post-operative assessments.
2. Begin by entering your personal information accurately, including your full name, date of birth, and contact details.
3. Next, provide a detailed surgical history by listing all previous abdominal surgeries you have undergone, including the type of surgery, date, and the name of the surgeon who performed it.
4. Include information about any pre-existing medical conditions you have, such as diabetes, heart disease, or respiratory problems. Mention the medications you are currently taking for these conditions, and any changes in medication since your surgery.
5. Record your weight history, noting your highest weight and your current weight. Include information about any significant weight loss or gain prior to your bariatric surgery.
6. Document your diet and exercise habits before and after the surgery. Include any specific dietary restrictions or modifications you have adopted post-surgery.
7. Provide a detailed account of your psychological health and well-being before and after the surgery. Mention any emotional or mental health concerns, such as anxiety or depression, and any therapy or counseling you have received.
8. Include information about your lifestyle changes post-surgery, such as smoking cessation, alcohol or substance abuse, and stress management techniques.

Who needs bariatric history?

1. Bariatric surgeons: Bariatric surgeons require a complete and accurate bariatric history to assess the patient's eligibility for surgery, identify potential risks, and tailor the surgical approach accordingly.
2. Primary care physicians: Primary care physicians play a crucial role in the long-term management of bariatric surgery patients. They require the bariatric history to understand the patient's medical background, monitor post-operative progress, and provide comprehensive care.
3. Registered dietitians/nutritionists: Bariatric history is necessary for dietitians and nutritionists to develop personalized meal plans, assess nutritional deficiencies, and educate patients about the dietary changes required before and after surgery.
4. Psychologists/mental health professionals: Bariatric history provides crucial insights into a patient's mental health, helping psychologists and mental health professionals identify and address any pre-existing or post-surgery psychological concerns.
5. Insurance providers: Insurance providers may require a thorough bariatric history to evaluate a patient's eligibility for coverage and determine the extent of coverage for bariatric surgery-related procedures.
6. Research institutions: Bariatric history data can contribute to research studies and help researchers understand the long-term outcomes, potential complications, and efficacy of bariatric surgery.

Overall, the bariatric history serves as a vital document for healthcare professionals involved in the care and management of bariatric surgery patients, ensuring a comprehensive understanding of the patient's medical, surgical, nutritional, and psychological background.

For pdfFiller’s FAQs

What is bariatric history?

Bariatric history refers to a patient's medical history related to weight loss surgery.

Who is required to file bariatric history?

Patients who have undergone or are considering weight loss surgery are required to file bariatric history.

How to fill out bariatric history?

Bariatric history can be filled out by providing detailed information about previous weight loss surgeries, medical conditions, medications, and lifestyle habits.

What is the purpose of bariatric history?

The purpose of bariatric history is to assess the patient's suitability for weight loss surgery, identify potential risks, and tailor the treatment plan accordingly.

What information must be reported on bariatric history?

Information such as previous weight loss surgeries, medical conditions, medications, allergies, lifestyle habits, and family history of obesity must be reported on bariatric history.

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