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ST Luke's Weight Management Center Personal History Form Behavioral Health Assessment Patient Name Date of Birth BMI/WEIGHT Directions: Please complete the following questionnaire to the best of your

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How to fill out st lukes bariatric services

How to fill out St. Luke's bariatric services:

01

Visit St. Luke's website or contact their office to obtain the necessary paperwork.

02

Fill out your personal information accurately, including your name, contact information, and insurance details.

03

Provide a detailed medical history, including any previous surgeries, any existing medical conditions, and a list of medications you are currently taking.

04

Indicate your reasons for seeking bariatric services at St. Luke's and any specific concerns or goals you may have.

05

Include any relevant test results or medical documents that you have, such as recent bloodwork or evaluations from other healthcare professionals.

06

If you have any questions or require assistance with the application process, reach out to St. Luke's bariatric services office for guidance.

Who needs St. Luke's bariatric services:

01

Individuals who have struggled with obesity and have not been successful in losing weight through other methods such as diet and exercise.

02

Patients with obesity-related health issues, such as diabetes, high blood pressure, or sleep apnea, that could potentially improve with weight loss.

03

Those who have a body mass index (BMI) of 40 or higher, or a BMI of 35 to 39.9 with significant obesity-related health conditions.

04

People who have undergone previous weight loss attempts but have experienced weight regain.

05

Individuals who are committed to making long-term lifestyle changes and are willing to adhere to the necessary post-surgical guidelines and recommendations.

Please note that this information should be double-checked with St. Luke's bariatric services for their specific requirements and criteria.

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What is st lukes bariatric services?

St. Luke's Bariatric services is a specialized program that provides support and treatment for patients struggling with obesity.

Who is required to file st lukes bariatric services?

Patients who are seeking treatment or support for obesity through St. Luke's Bariatric services are required to complete the necessary paperwork.

How to fill out st lukes bariatric services?

Patients can fill out the paperwork for St. Luke's Bariatric services by following the instructions provided by the program staff.

What is the purpose of st lukes bariatric services?

The purpose of St. Luke's Bariatric services is to provide comprehensive care and support for individuals struggling with obesity.

What information must be reported on st lukes bariatric services?

The information reported on St. Luke's Bariatric services typically includes medical history, current weight, lifestyle habits, and treatment goals.

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