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875 Oak Street SE Suite 5040 Salem, OR 97301 Phone 503-561-5286 Fa — 503-561-3479 Physician Supervised Non-Surgical Weight Loss Program Form Instructions: Patient presents this form at each visit
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Physician supervised non-surgical weight is a weight management program overseen by a healthcare provider that does not involve surgical procedures.
Individuals who are participating in a physician supervised non-surgical weight program may be required to file related information.
To fill out physician supervised non-surgical weight, individuals typically need to provide information about their weight loss progress, medical history, and any medications or treatments received.
The purpose of physician supervised non-surgical weight is to help individuals achieve their weight loss goals in a safe and effective manner under the supervision of a healthcare provider.
Information that may need to be reported on physician supervised non-surgical weight includes weight loss progress, medical history, medications, and treatments received during the program.
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