Get the free WOAH Bariatric Surgery Evaluation Referral

If all the above answers are yes, please submit a standard referral form for the initial evaluation. Include the appropriate ICD-10 codes for both diabetes and ...

How to fill out woah bariatric surgery evaluation

How to fill out woah bariatric surgery evaluation:

1. Start by carefully reading through the evaluation form. Understand the purpose of each section and the information required for each question.
2. Begin with personal information. Fill out your name, contact details, date of birth, and other necessary identification information.
3. Move on to the medical history section. Provide accurate and comprehensive information about any previous surgeries, chronic illnesses, medical conditions, and medications you are currently taking.
4. Fill in details about your previous weight loss attempts. Include information about diets, exercise routines, and any professional weight loss programs you have tried in the past.
5. Answer questions related to your psychological well-being. This section may ask about your motivation for surgery, emotional stability, and any history of mental health issues.
6. Provide details about your dietary habits. Mention the types of food you consume regularly, any specific dietary restrictions or allergies you have, and your food preferences.
7. Answer questions about your physical activity level. Describe your exercise routine, if any, and any physical limitations or restrictions that may affect your ability to engage in certain activities.
8. Fill in information regarding your social support network. Include details about your family members, friends, or support groups who can provide assistance and encouragement throughout your weight loss journey.
9. Provide a detailed account of your eating patterns and behaviors. Answer questions about emotional eating, binge eating, snacking habits, and any past or current eating disorders.
10. Submit any additional required documents such as medical reports, test results, or a referral from your primary healthcare provider.

Who needs woah bariatric surgery evaluation?

1. Individuals who have been advised by their healthcare provider to consider bariatric surgery as a treatment option for severe obesity.
2. Individuals who have struggled with significant weight gain and have not been able to successfully lose weight through conventional methods such as diet and exercise.
3. Individuals who meet specific criteria set by the healthcare provider or the bariatric surgery center, such as having a body mass index (BMI) above a certain threshold.
4. Individuals who have been screened and determined to be physically and psychologically suitable candidates for bariatric surgery.
5. Individuals who understand the potential risks and benefits of bariatric surgery and are willing to commit to the lifestyle changes required for successful long-term weight loss.

Remember, it is crucial to consult with a qualified healthcare professional or bariatric surgery center for personalized guidance and advice regarding the evaluation process and suitability for surgery.

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